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MELAS 증후군과 미토콘드리아 근육병에서의 Tc-99m ECD 뇌 단일 광전자방출 전산화단층촬영 소견 - 자기공명영상과의 비교
유영훈(Young Hoon Ryu),이종두(Jong Doo Lee),윤평호(Pyeong Ho Yoon),김재근(Jai Keun Kim),박상준(Sang Joon Park),전태주(Tae Joo Jeon),남지은(Ji Eun Nam),윤춘식(Choon Sik Yoon) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.6
N/A Purpose: We evaluated brain perfusion SPECT findings of MELAS syndrome and mitochondrial myopathy in correlation with MR imaging in search of specific imaging features. Materials and Methods: Subjects were five patients (four females and one male; age range, 1 to 25 year) who presented with repeated stroke-like episodes, seizures or developmental delay or asymptomatic but had elevated lactic acid in CSF and serum. Conventional non-contrast MR imaging and Tc-99m-ethyl cysteinate dimer (ECD) brain perfusion SPECT were performed and imaging features were analyzed. Results: MRI demonstrated increased T2 signal intensities in the affected areas of gray and white matters mainly in the parietal (4/5) and occipital lobes (4/5) and in the basal ganglia (1/5), which were not restricted to a specific vascular territory. SPECT demonstrated decreased perfusion in the corresponding regions of MRI lesions. In addition, there were perfusion defects in parietal (1 patient), temporal (2), and frontal (1) lobes and basal ganglia (1) and thalami (2). In a patient with mitochondrial myopathy who had normal MRI, decreased perfusion was noted in left parietal area and bilateral thalami. Conclusion: Tc-99m ECD SPECT imaging in patients with MELAS syndrome and mitochondrial myopathy showed hypoperfusion of parieto-occipital cortex, basal ganglia, thalamus and temporal cortex, which were not restricted to a specific vascular territory. There were no specific imaging features on SPECT. The significance of abnormal perfusion on SPECT without corresponding MR abnormalities needs to be evaluated further in larger number of patients.
전신 홍반 루푸스에서 발생한 Miller Fisher 증후군 1예
김혜영 ( Hye Young Kim ),이찬희 ( Chan Hee Lee ),조정희 ( Jeong Hee Cho ),윤평호 ( Pyeong Ho Yoon ),이용강 ( Yong Kang Lee ),박윤혜 ( Yoon Hye Park ),최아라 ( Ara Choi ) 대한내과학회 2012 대한내과학회지 Vol.83 No.5
Neuropsychiatric events are common in patients with systemic lupus erythematosus (SLE). The estimated incidence of neuropsychiatric SLE (NPSLE) is 30 to 40%. However, NPSLE poses a difficult diagnostic challenge because a variety of conditions should be considered in the differential diagnosis, especially when patients present with uncommon or rare NPSLE features. We herein describe a 49-year-old man with SLE who initially presented with diplopia, ptosis, and gait disturbance that had developed 1 week after an upper respiratory tract infection. He was finally diagnosed with Miller Fisher syndrome (a variant of Guillain-Barr? syndrome) according to clinical symptoms, anti-GQ1b antibody positivity, and neurological study results. The patient recovered without sequelae with intravenous immunoglobulin therapy. This is the first report to describe a case of Miller Fisher syndrome that developed in a patient with SLE in Korea and suggests that Miller Fisher syndrome should be included as a differential diagnosis of NPSLE. (Korean J Med 2012;83:683-687)
두개강 및 경부의 외상성 혈관 손상: 혈관내 치료의 유용성
최은완 ( Eun Wan Choi ),문태일 ( Tae Il Moon ),이정한 ( Jeong Han Lee ),추용식 ( Yong Sik Chu ),배진건 ( Jin Kun Bae ),김옥준 ( Ok Jun Kim ),최성욱 ( Seong Wook Choi ),안정용 ( Jung Yong Ahn ),윤평호 ( Pyeong Ho Yoon ),김상흠 ( Sa 대한외상학회 2004 大韓外傷學會誌 Vol.17 No.2
Background: The diagnosis and management of traumatic craniocervical vessel injuries in emergency department continue to be controversial. Direct surgical repair with parent artery preservation may be still difficult. The purpose of this report is to determine the safety and efficacy of endovascular therapy in the management of craniocervical vascular injuries. Methods: Fifteen patients with traumatic carotid and vertebral lesions were treated using therapeutic endovascular methods. Endovascular therapy was accomplished by implanting the balloons, porous or polytetrafluoroethylene (PTFE)-covered stent, and/or embolic materials including coils or glue. Results: All fistulas and pseudoaneurysms were successfully embolized with coils, glue, or stents. The parent arteries of all patients except two patients were preserved. The reasons of the parent artery sacrifice are that thrombus formation due to coil migration into the parent artery and the existing transection of the parent artery, respectively. No additional surgical procedures for vascular lesions were required. There were no delayed neurological or vascular complications and no lesions recurred during follow-up periods (mean 26.9 months). Conclusion: The goal of endovascular therapy is the selective elimination of the vascular pathology with the normal patency of the cerebral arteries. The author`s experience demonstrates that endovascular therapy using stents, balloons, and coils is both feasible and safe in treatment of the traumatic vascular injuries. Long-term follow-up review of these repairs will be necessary to provide a full evaluation of the safety and efficacy of these devices.