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산전 진단된 단독 태아 뇌실확장증의 임상적 고찰: 175예의 후향적 분석
정의 ( Eui Jung ),오지영 ( Jee Young Oh ),김선권 ( Sun Kwon Kim ),심재윤 ( Jae Yoon Shim ),원혜성 ( Hye Sung Won ),이필량 ( Pil Ryang Lee ),김암 ( Ahm Kim ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.6
목적: 단독 태아 뇌실확장증의 자연 경과와 출생 후 예후 및 뇌실확장증의 정도와 발달 장애 여부와의 연관성을 살펴보고, 산전 관리 및 상담에 도움을 주고자 본 연구를 시행하였다. 연구 방법: 1996년 10월부터 2004년 6월까지 본원 산부인과에서 시행한 산전 초음파 검사에서 단독 태아 뇌실확장증으로 진단된 175명의 단태임신을 대상으로 후향적으로 의무기록을 조사하였다. 뇌실의 크기는 15㎜를 기준으로 경증 뇌실확장증과 중증 뇌실확장증으로 나누었으며 경증 뇌실확장증은 다시 12㎜미만인 경우를 추가로 비교하였다. 출생 후 뇌 초음파 검사 및 자기공명영상을 시행하였으며, 외래 추적 관찰과 보호자와 전화 면담을 통해 발달 장애 유무를 조사하였다. 결과: 단독 태아 뇌실확장증으로 진단된 총 175명 중 남아에서 더 빈도가 높았으며 1예에서 다운증후군으로 진단이 되었다. 임신 중 태아 뇌실확장증이 정상으로 회복된 군에서 평균 뇌실의 크기가 더 작았으며, 일측성인 경우가 많았다. 첫 진단 당시 뇌실의 크기가 15㎜이상인 경우는 단 1예도 감소하는 양상을 보이지 않아 뇌실확장 정도가 심할수록 정상으로 회복되는 확률이 낮은 것으로 나타났다. 뇌실의 크기가 12㎜미만인 경우는 총 131명이 있었으며 출생 후 발달장애는 없었지만 뇌성마비와 유전 질환이 각각 2예씩 있었다 뇌실의 크기가 15㎜이상인 경우 임신을 종결한 1예를 제외한 16예 중 6예에서 발달 장애가, 1예에서 뇌성마비가 발생했고 유전 질환을 제외한 나머지 8예는 정상 발달을 보였다. 결론: 산전 초음파 검사상 단독 태아 뇌실확장증 중 경증 또는 일측성 뇌실확장증이거나 추적 검사시 뇌실의 크기 증가가 없는 경우는 예후가 좋으나, 유전 질환이나 증후군과의 연관성 및 대뇌 발달 장애의 한 표시일 수 있음을 주지해야 할 것으로 판단된다. Objective: The objective of this study is to evaluate the natural course, postnatal outcome, and association between the degree of ventriculomegaly and neurodevelopmental delay in isolated fetal ventriculomegaly. Methods: We reviewed the medical records of pregnant women diagnosed with isolated fetal ventriculomegaly from October 1996 to June 2004. We defined mild ventriculomegaly as atrial width of 10-14.9㎜ and overt ventriculomegaly as 15㎜ or more. Neonatal brain ultrasonography was performed in all cases and brain MRI was performed as necessary. Neurodevelopmental outcome was evaluated by medical records and telephone interviews. We analyzed the final outcome of isolated fetal ventriculomegaly according to the ventricular width. Results: There were 175 cases of isolated fetal ventriculomegaly, with a large proportion of male fetuses (68.6%), and one case of trisomy 21. While the group with prenatally resolved ventriculomegaly (n=119) had a smaller ventricular width and more unilaterality, there was no resolution in cases with a ventricular width of 15㎜ or more. One hundred and thirty one fetuses with an initial ventricular width of 10 to 11.9㎜ had no developmental delay, however, there were 2 cases of cerebral palsy and 2 cases of genetic disorder. Seventeen fetuses had ventricular dilatation of 15㎜ or more, with 6 corresponding cases of developmental delay and one case of cerebral palsy. Conclusion: Among isolated fetal ventriculomegaly, mild, unilateral or stable ventriculomegaly seems to have a favorable neurological outcome, especially those cases with ventricular width of less than 12㎜. However, management of the condition and counseling of parents are still crucial, because it can be a marker of genetic disorder or brain developmental delay.
전이경,김혜선,홍성란,지제근 대한의학회 2010 Journal of Korean medical science Vol.25 No.6
We report two autopsy cases that revealed the partial absence of the septum pellucidum with ventriculomegaly. In each case, the brain showed mild dilatation of both frontal horns of the lateral ventricles, normal third and fourth ventricles and no aqueductal stenosis. The posterior portion of the septum pellucidum was absent and the fornices were fused in a single midline nodule, abnormally displaced to a caudal position and lodged in the foramina of Monro. The brain base showed no apparent abnormalities;the optic nerves were well developed. We conclude that the caudally displaced fornix in the absence of the septum pellucidum may have intermittently obstructed the foramina of Monro and induced mild ventriculomegaly.
산전 검사 상 발견된 태아 뇌실 확장증의 초음파적 예후 인자
김윤환 ( Yun Hwan Kim ),이시은 ( Si Eun Lee ),박찬욱 ( Chan Wook Park ),손유경 ( Yoo Kyung Sohn ),오수영 ( Soo Young Oh ),심순섭 ( Soon Sup Shim ),박중신 ( Joong Shin Park ),전종관 ( Jong Kwan Jun ),윤보현 ( Bo Hyun Yoon ),신희철 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.2
목적: 이 연구의 목적은 산전 초음파 검사 상 발견된 태아 뇌실확장에 대한 초음파적 예후 인자를 찾기 위함이다. 연구 방법: 1995년 11월부터 2003년 1월까지 산전 초음파 검사 상 태아 뇌실확장이 진단된 96예의 단태임신을 대상으로 산전 및 산후 추적 관찰한 의료기록을 후향적으로 검토하였다. 태아 생존연령 이전에 임신 종결이 시행된 경우와 추적관찰이 이루어지지 못한 증례들을 제외하고 68예가 연구의 대상이 되었다. 중증 뇌실 확장 (태아 뇌수종; Objective: The aim of this study was to find out the prognostic indicators of antenatally detected ventriculomegaly. Methods: During the study period (Nov. 1995 through Jan. 2003), we identified 96 cases of fetal ventriculomegaly and reviewed their antena
김성(Sung Kim),이동민(Dong Min Lee),김호영(Ho Young Kim),김재연(Jae Yun Kim),최영렬(Young Ryoul Choi),유재경(Jae Kyoung Yoo),윤길중(Gil Jung Yoon),황인수(In Su Hwang) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.11
The prenatal diagnosis of spine bifida include the combined use of maternal serum α-fetoprotein (MSAFP) screening and fetal sonography. Sonographically, spina bifida is characterized by direct signs of the visualization of the spinal defect, and indirect signs of the cranial markers : the lemon sign, the banana sign, and ventriculomegaly. These ultrasonographic signs are more accurate in defining the cranial malformations associated with spina bifida than evaluation of the spine. Recently, three cases of spina bifida which was diagnosed as splaying of the posterior ossification centers, meningomyelocele sac at the lumbosacral area, lemon sign, banana sign and ventriculomegaly by ultrasonography at 21+2 gestational weeks in a 32 years old nullipara, at 21+2 gestational weeks in a 26 years old nullipara, at 23+6 gestational weeks in a 26 years old multipara were experienced at our department. We present this cases with a brief review of literatures
성인 뇌실 확장증에서 SHUNT 수술 적응을 결정하기 위한 Continuous ICP Monitoring의 적용
윤수한,조경기,안영민,안영환 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.12
We evaluated one month follow-up results of the 12 adult patients who showed ventriculomegaly in the aspects of symptoms. Evans ratio, periventricular low density grades of radio-isotope cisternography and grades of continuous intracranial pressure monitoring that were classified on the pressure wave and basal pressure level. The grades of continuous ICP monitoring were compared to the grades of radio-isotope cisternography. History symptoms CT findings and radio-isotope cisternography are often helpful to decide shunt operation but sometimes continuous intracranial pressure monitoring gives invaluable information.
Prenatal Diagnosis of Transient Abnormal Myelopoiesis in a Down Syndrome Fetus
김광준,이은실 대한영상의학회 2009 Korean Journal of Radiology Vol.10 No.2
We report a case of transient abnormal myelopoiesis in a Down syndrome fetus diagnosed at 28+3 weeks of gestation that rapidly progressed to intrauterine death 10 days later. Fetal hepatosplenomegaly with cerebral ventriculomegaly, although not specific, may be a suggestive finding of Down syndrome with transient abnormal myelopoiesis. Prompt fetal blood sampling for liver function test and chromosomal analysis are mandatory for early detection and management.
임신 말기 뇌실확장증 및 미성숙폐가 합병된 과도신전 경부의 태아
정재원 ( Jae Won Chung ),이은성 ( Eun Sung Lee ),백유진 ( Yu Chin Paek ),이경희 ( Kyung Hee Lee ),설현주 ( Hyun Joo Seol ),오민정 ( Min Jeong Oh ),김해중 ( Hai Joong Kim ) 대한주산의학회 2006 Perinatology Vol.17 No.3
과도신전된 태아두(hyperextended neck)는 산전초음파로 발견되어질 수 있는 다양한 태위들 중 하나로 과도신전된 태아두를 진단하는 것은 중요한 일인데 특히 질식분만을 시도하게 되는 경우 경추손상의 위험도가 증가하기 때문이다. 또한 지속적인 과도신전된 경부를 보이는 태아에서는 구조적 이상의 동반 및 다양한 증후군과 연관될 가능성이 높고 구조적 이상이 동반된 경우 자궁내 또는 출생 후 사망이나 질병이환률이 현저히 증가한다고 알려져 있다. 따라서 과도신전된 경부를 보이는 태아에서 다른 구조적 이상여부 확인을 위해 좀 더 자세한 평가를 하고 그에 따르는 적절한 조치가 필요하다. 본 저자들은 산전임신중반기에 발견된 과도신전된 경부를 가진 태아가 임신후반기에 뇌실확장 및 폐미성숙 소견을 보였던 1예를 경험하였기에 증례 보고하는 바이다. Hyperextended neck of the fetal head is among the various fetal attitudes detected by prenatal sonography. Various etiologies may lead to hyperextension of the fetal head, including fetal anomalies such as structural abnormalities, conjoined twins and fetal neck masses, nuchal cord and uterine factors such as leiomyoma and uterine malformations. The importance of the precise prenatal diagnosis of this condition relates not only to the delivery mode, but also to the detection of associated conditions, as noted above. We report a case of a fetus whose persistent hyperextended neck was detected by midtrimester sonography, and who later demonstrated ventriculomegaly and lung immaturity in the 3rd trimester.
최호정,이기자,안세준,권영항,정기영,이희천,이영원 한국임상수의학회 2011 한국임상수의학회지 Vol.28 No.1
This study was performed to evaluate the size and asymmetry of the lateral ventricles in CT images of three different small breed dogs. CT examinations were performed on thirty Yorkshire terriers, malteses, and shihtzu dogs, respectively. The size and asymmetry of their lateral ventricles were evaluated at three different levels of brain, and dogs were categorized on the basis of the percentage of their ventricular height (Vh) to brain height (Bh). Degree of asymmetry was also categorized based on the rVh (ratio of right and left ventricular heights) as normal (rVh < 1.5), mild (1.5 < rVh < 2.0), or severe (2.0 < rVh). Clinically insignificant ventricular dilation was common in these breed dogs. However, severe asymmetry was not presented in clinically normal dogs. We suggested 11 mm as an upper limit of ventricular size in normal small breed dogs.
치와와에서 발생한 외상적 뇌손상 증례; 연속적인 임상적 및 전산화 단층영상 소견
이희천,원진희,문종현,정해원,정동인 한국임상수의학회 2014 한국임상수의학회지 Vol.31 No.4
A dog (Chihuahua, 2-year-old, intact female) was referred to us because of cluster seizure. She had historyof falling from height few days before presentation. Brain computed tomography (CT) results demonstrated fractureline on right temporal bone and hypodense, edematous changes of the adjacent brain parenchyma on right cerebralparenchyma. Based on history, clinical signs, and diagnostic imaging findings, this patient was diagnosed to traumaticbrain injury. After diagnosis, the patient was well controlled with anti-inflammatory drug and anti-epileptic drugs. When30, 480, and 1260 days after initial brain CT examination, we performed serial brain CT rechecks. This case reportdescribes serial clinical and brain CT findings after traumatic brain injury.