Journal of Yeungnam Medical Science

Volume 25(2); December 2008

Review

Quality Assurance in Intensity Modulated Radiation Theray.: Sung Kyu Kim; Yeungnam Univ J Med. 2008;25(2):85-91. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.85

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Abstract PDF: Intensity-modulated radiation therapy (IMRT) is believed to be one of the best radiation treatment techniques. IMRT is able to deliver fatal doses of radiation to the tumor region with minimal exposure of critical organs. It is essential to have a comprehensive quality assurance program to assure precision and accuracy in treatment, due to the character of IMRT. We applied quality assurance technique to the Eclipse treatment planning system and sought to determine its effectiveness in patient treatment planning. An acrylic phantom, film, and an ionization chamber were used in this study.

Original Articles

Study on Perception of Their Body Image and Body Dissatisfaction in Adolescent in Ulsan.: Chan Eui Hong, Sung Wan Hong, Chul Zoo Jung, Dong Jin Lee, Kwang Hae Choi; Yeungnam Univ J Med. 2008;25(2):92-101. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.92

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Abstract PDF

BACKGROUND
In this study, we examined body image perception and dissatisfaction with weight and height in children and adolescents, according to age and body mass index. Additionally, we compared our findings with those of previous studies concerning eating disorders. MATERIALS AND METHODS: In July and August 2008, 1,501 students were sampled from elementary, middle, and high schools in Ulsan and assessed using self-completion questionnaires. We used the Korean version of the Eating Attitude Test-26 (EAT-26) to screen for eating risk groups. Participants were stratified by grade, gender, and body mass index. RESULTS: 1) Dissatisfaction with height, weight, and body image was greater in the older group. 2) Dissatisfaction with weight and body image was greater in the heavier group. 3) EAT-26 scores and the number of individuals at high risk for eating disorders were higher in the female group than in the male group. CONCLUSION: The EAT-26 score in this study was similar to those found in previous Western studies. 2) There were a number of high-risk individuals in the female group, with a tendency toward earlier presentation. Continuous health management and prevention programs are required.

Citations

Citations to this article as recorded by

Survey on Kimchi Intake Patterns and Attitudes towards Development of Functional Kimchi among Middle and High School Students in Busan Area
Ga-Yeong Lee, Eui Seong Park, Kun-Young Park
Journal of the Korean Society of Food Science and Nutrition.2015; 44(8): 1226. CrossRef
Body Image, Risk of Disturbed Eating Attitudes and Weight Control of Female Junior High School Students by the Body Mass Index in Seoul
Hyun-Jung Song, Hyun-Kyung Moon
Korean Journal of Community Nutrition.2014; 19(2): 111. CrossRef

The Role of Dynamic CT for the Differential Diagnosis of Solitary Pulmonary Nodule.: Jin Hong Chung, Won Jong Park, Ihn Ho Cho; Yeungnam Univ J Med. 2008;25(2):102-107. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.102

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Abstract PDF: BACKGROUND
Malignant pulmonary nodules account for 30 to 40 percent of all solitary pulmonary nodules (SPNs). Therefore, characterization of SPNs is very important for treatment. Recently, dynamic CT has been widely used for tissue characterization and formation of differential diagnoses. The purpose of this study was to evaluate the ability of dynamic CT to formulate the differential diagnosis of SPNs. MATERIALS AND METHODS: Nineteen patients with SPNs underwent dynamic CT (unenhanced scans, followed by a series of images at 20, 40, 60, 80, 100, 120, 140, 160, and 180 sec after intravenous injection of contrast medium). Diagnosis of SPN was performed based on pathologic findings in needle biopsy samples. Peak enhancement, net enhancement, slope of enhancement, and maximum relative enhancement ratio of the SPN were measured on dynamic CT, and Levene's test was performed to assess benignancy and malignancy. RESULTS: Twelve SPNs were confirmed to have malignant pathology. There were no significant differences between benign and malignant nodules with respect to peak enhancement (p=0.787), net enhancement (p=0.135), or slope of enhancement (p=0.698). The maximal enhancement ratio was increased in malignancy compared to benignancy, but the difference was not statistically significant (p=0.094). CONCLUSION: In our study, the hemodynamic characteristics of dynamic CT were not significantly different between benign and malignant nodules. Therefore, long-term studies of larger patient samples are required to confirm our findings.

Comparision of Mandible Changes on Three-Dimensional Computed Tomography image After Mandibular Surgery in Facial Asymmetry Patients.: Mi Ryoung Kim, Byung Rho Chin; Yeungnam Univ J Med. 2008;25(2):108-116. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.108

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Abstract PDF: BACKGROUND
When surgeons plan mandible ortho surgery for patients with skeletal class III facial asymmetry, they must be consider the exact method of surgery for correction of the facial asymmetry. Three-dimensional (3D) CT imaging is efficient in depicting specific structures in the craniofacial area. It reproduces actual measurements by minimizing errors from patient movement and allows for image magnification. Due to the rapid development of digital image technology and the expansion of treatment range, rapid progress has been made in the study of three-dimensional facial skeleton analysis. The purpose of this study was to conduct 3D CT image comparisons of mandible changes after mandibular surgery in facial asymmetry patients. MATERIALS & METHODS: This study included 7 patients who underwent 3D CT before and after correction of facial asymmetry in the oral and maxillofacial surgery department of Yeungnam University Hospital between August 2002 and November 2005. Patients included 2 males and 5 females, with ages ranging from 16 years to 30 years (average 21.4 years). Frontal CT images were obtained before and after surgery, and changes in mandible angle and length were measured. RESULTS: When we compared the measurements obtained before and after mandibular surgery in facial asymmetry patients, correction of facial asymmetry was identified on the "after" images. The mean difference between the right and left mandibular angles before mandibular surgery was 7degrees, whereas after mandibular surgery it was 1.5degrees. The right and left mandibular length ratios subtracted from 1 was 0.114 before mandibular surgery, while it was 0.036 after mandibular surgery. The differences were analyzed using the nonparametric test and the Wilcoxon signed ranks test (p<0.05). CONCLUSION: The system that has been developed produces an accurate three-dimensional representation of the skull, upon which individualized surgery of the skull and jaws is easily performed. The system also permits accurate measurement and monitoring of postsurgical changes to the face and jaws through reproducible and noninvasive means.

Case Reports

A Case of Dermatomyositis with Secondary Organizing Pneumonia.: Chul Yun Park, Jung Seok Chung, Jin Wook Chung, Choong Ki Lee, Dae Sung Hyun, Jung Yoon Choe; Yeungnam Univ J Med. 2008;25(2):117-123. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.117

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Abstract PDF: Dermatomyositis is characterized by progressive, symmetric, proximal muscle weakness and a nonsuppurative inflammatory myopathy of unknown etiology involving predominantly skeletal muscles. It is also characterized by typical skin lesions. Interstitial lung disease has a poor prognosis when it is associated with dermatomyositis. Organizing pneumonia is a disease in which granulation tissue fills the lumina of terminal and respiratory bronchioles and extends into the distal airspaces. The cryptogenic nature of the process is appreciated in that organizing pneumonia patterns of injury can be seen in secondary forms of the disease (secondary organizing pneumonia). Organizing pneumonia has been reported to occur in 5~10% in dermatomyositis-polymyositis patients. Anti-histidyl tRNA synthetase antibody (anti-Jo-1) is a predictive disease marker that is reported to occur in up to 70% of patients. We describe a 49-year-old male dermatomyositis patient who presented with organizing pneumonia and was found to have negative anti-Jo-1 antibody.

A Case of Leiomyoma of The Lateral Vaginal Wall.: Sung Chul Park, Doo Jin Lee, Sung Ho Lee, Yoon Ki Park; Yeungnam Univ J Med. 2008;25(2):124-127. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.124

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Abstract PDF: Leiomyomas are common in the myometrial layer of the uterus, though they are rarely found in other reproductive organs. Leiomyomas are benign, hormone-sensitive smooth muscle tumors. They develop during the reproductive years and regress after menopause. Preoperative diagnosis is difficult to make. We present a case of a 54-year-old woman with a vaginal wall tumor. The management in this case included surgical excision. Histologic examination definitively confirmed the diagnosis of a vaginal leiomyoma. We report the details of this case along with a brief review of the literature.

A Case of Pancreatic Acinar Cell Carcinoma.: Hwa Jung Lee, Jun Ho Ji, Seung Chan Park, Jung Chul Park, Eun Jung Choi, Hye Jin Seo, Won Sik Lee, Jung Lim Lee, Byung Jo Bae, Kyung Rak Shon, Kyung Hee Lee; Yeungnam Univ J Med. 2008;25(2):128-133. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.128

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Abstract PDF: Acinar cell carcinoma is a rare tumor that represents 1~2% of all pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease. Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-old man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased 18F-fluorodeoxyglucose (FDG) uptake. Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the pancreas. The patient underwent a total gastrectomy three months later because of gastric recurrence. Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy. During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabine.

A Case of Primary Mucinous Cystadenocarcinoma.: Jun Ho Ji, Hwa Jung Lee, Seung Chan Park, Jung Chul Park, Eun Jung Choi, Hye Jin Seo, Won Sik Lee, Jung Lim Lee, Byung Jo Bae, Kyung Rak Shon, Kyung Hee Lee; Yeungnam Univ J Med. 2008;25(2):134-138. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.134

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Abstract PDF

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its pathogenesis, optimal treatment, and prognosis. A 29-year-old pregnant woman (21 weeks) presented with abdominal discomfort. CA 19-9, CA 125, and CEA were normal. Abdominal CT scanning revealed a 19x15x13 cm retroperitoneal tumor. Exploratory laparotomy and tumor excision were performed. Mucinous retroperitoneal implants were removed as completely as possible. Histologically, the tumor showed focal areas of capsular invasion, but free resection margins. The uterus and both ovaries were normal in appearance. No adjuvant therapy was pursued. Six months later, peritoneal and bilateral ovarian metastases were discovered.Hence, we report the details of this case of primary retroperitoneal mucinous cystadeno-carcinoma and present a review of the literature.

Citations

Citations to this article as recorded by

MR Imaging of Primary Retroperitoneal Mucinous Cystadenocarcinoma in Pregnant Woman
Jisun Lee, Bum Sang Cho, Yook Kim, Kyung Sik Yi, Min Ho Kang, Seung Young Lee, Sung Jin Kim, Kil Sun Park
Journal of the Korean Society of Magnetic Resonance in Medicine.2013; 17(3): 243. CrossRef

Pediatric Crohn's Disease presenting as Severe Constipation and Abdominal Distension.: Myong Soon Sung, Seok Jeong Kang, Kwang Hae Choi; Yeungnam Univ J Med. 2008;25(2):139-144. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.139

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Abstract PDF: Crohn's disease is a chronic inflammatory bowel disease that mainly affects children and young adults. Its cause remains unknown. The incidence of pediatric Crohn's disease is increasing, so it is important for clinicians to be aware of the presentation of this disease in the pediatric population. The majority of patients complain of abdominal pain (72%), with only 25% presenting with the 'classical triad' of abdominal pain, weight loss, and diarrhea. Many children with Crohn's disease present in a 'non-classical' manner, with vague complaints such as lethargy or anorexia, which may be associated with only mild abdominal discomfort. Other symptoms include fever, nausea, vomiting, growth retardation, malnutrition, delayed puberty, psychiatric symptoms, arthropathy, and erythema nodosum. Severe constipation and abdominal distension are uncommon symptoms at diagnosis. We report a case of pediatric Crohn's disease, which was diagnosed after the patient presented with severe constipation and abdominal distension.

Mastoid Osteoma with Mastoiditis.: Yong Dae Kim, Si Youn Song, Chang Hoon Bae; Yeungnam Univ J Med. 2008;25(2):145-149. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.145

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Abstract PDF: Osteomas are benign osteoblastic tumors that occur mainly in the fronto-ethmoid areas ofthe head and neck region. When they occasionally occur in the temporal bone, the external auditory canal is the most common site of origin; they rarely occur in the mastoid region. Moreover, mastoid osteoma with mastoiditis is an extremely rare entity in the temporal bone. Recently, the authors experienced a case of mastoid osteoma with mastoiditis in the left temporal bone. The mastoid osteoma was completely resected itself without a mastoidectomy, only for correction of the cosmetic deformity; the mastoiditis was not treated. Hence, the authors report the first case of a mastoid osteoma with mastoiditis in Korea, along with a review of the related literature.

Anesthetic Induction in a Sitting Position for a Patient with Congestive Heart Failure.: Seung Dong Kim, Gul Jung, Dae Lim Jee; Yeungnam Univ J Med. 2008;25(2):150-153. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.150

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Abstract PDF: A 67-year-old woman with severe congestive heart failure (New York Heart Association, NYHA class IV) was set to receive general anesthesia for cardiac surgery. For several months, she had been in a constant sitting position from which the slightest change evoked dyspnea. A patient in such a condition is rarely considered a candidate for general anesthesia, because such patients are never eligible for any type of surgery other than that used to fix the heart problem itself. We report this case to explain how anesthesia was induced with the patient sitting in a crouching position and discuss other methods of induction that can probably be used in similar situations.

Angioleiomyoma of the Nasal Septum: A Case Report.: Joon Hyuk Choi, Jun Mo Kim, Yong Dae Kim; Yeungnam Univ J Med. 2008;25(2):154-159. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.154

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Abstract PDF

Angioleiomyoma of the sinonasal tract is a rare benign tumor. We report a case of angioleiomyoma of the nasal septum in a 51-year-old woman who complained of frequent epistaxis for 3 months. Surgicalexcision was performed. The excised specimen was 0.7 x 0.5 x 0.4 cm in size, well circumscribed, grayish white, rubbery, and soft. Histological examination showed thick-walled blood vessels and smooth muscle cell proliferation. No nuclear atypia or mitoses were present.

Citations

Citations to this article as recorded by

A Case of Leiomyoma of the Nasal Septum
Sung Jae Heo, Jin Hyun Ryu, Jung Soo Kim
Journal of Clinical Otolaryngology Head and Neck Surgery.2016; 27(1): 133. CrossRef
A Case of Vascular Leiomyoma in Nasal Cavity: Case Report and Literature Review
Sung Won Yoon, Min Joon Park, Eun Mee Han, Jung Hyeob Sohn
Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2015; 58(2): 138. CrossRef
A Case of Angioleiomyoma of the Nasal Septum
Won Il Park, Ji Sung Shim, Junbum Joo, Ju Eun Cho
Journal of Clinical Otolaryngology Head and Neck Surgery.2013; 24(2): 247. CrossRef

Cystoperitoneal Shunting after Fenestration of an Enlarging Arachnoid Cyst.: Ik Chan Jeon, Min Su Kim, Seong Ho Kim, Sung Ho Jang; Yeungnam Univ J Med. 2008;25(2):160-164. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.160

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Abstract PDF: A two-month-old girl with a history of an incidental arachnoid cyst in the prenatal period (38 weeks) presented with persistent irritability. A follow-up computed tomographic (CT) scan revealed an enlarged arachnoid cyst with hydrocephalus. We performed craniotomy and fenestration, but the cyst size did not decrease, and hydrocephalus had worsened on a follow-up CT scan performed 13 months after fenestration. The patient was treated with cystoperitoneal shunting. Follow-up magnetic resonance imaging (MRI) performed 5 years later revealed that the arachnoid cyst had decreased in size and that the hydrocephalus had resolved. Enlarging arachnoid cysts are not common, and optimal surgical treatment is uncertain. Based on the features of this case, we believe cystoperitoneal shunting is an advisable surgical intervention for patients with enlarging arachnoid cysts presenting with hydrocephalus.

A Case of Hepatocellular Carcinoma with intradural growth Presenting as Obstructive Jaundice.: Sung Bum Kim, Tae Nyeun Kim, Sung Jun Kim, Ho Chan Lee, Jae Hyun Park, Jong Ryul Eun, Byung Ik Jang, Heon Ju Lee, Sung Su Yun, Young Kyung Bae; Yeungnam Univ J Med. 2008;25(2):165-170. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.165

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Abstract PDF: The incidence of hepatocellular carcinoma presenting as obstructive jaundice is 0.7~9%. The mechanisms of obstructive jaundice include bile duct invasion by tumor, tumor thrombi, blood clots, direct bile duct compression by tumor, and intraductal tumor growth. We report a rare case of hepatocellular carcinoma with intraductal growth. A 46-year-old woman was admitted due to colicky right upper abdominal pain and jaundice for 4 days. Computed tomography showed dilatation of the left intrahepatic duct, and endoscopic retrograde cholangiography showed a filling defect in the left main intrahepatic duct. We performed a left lobectomy with a Roux-en-Y hepaticojejunostomy. The tumor was diagnosed as a hepatocellular carcinoma with intraductal growth.

Sigmoid Colon Perforation by a Distal Ventriculoperitoneal Shunt Catheter.: Dong Keun Shin, Seong Ho Kim; Yeungnam Univ J Med. 2008;25(2):171-174. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.171

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Abstract PDF: We report an unusual case of a sigmoid colon perforation after ventriculoperitoneal shunt surgery. Distal catheters are known to cause perforation in the setting of colonoscopy. The exact pathogenesis of this complication is not clear, but it can cause serious complications. Hence, patients require prompt and aggressive management, including laparotomy with bowel wall repair, catheter removal, and antibiotic therapy.

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