, Min Hyouk Beak, Won-joong Kim Although sciatica is commonly associated with lumbar spinal issues, it is important to acknowledge that non-spinal factors can also play a significant role in this condition. This is particularly relevant for female patients, in whom gynecologic conditions can lead to secondary sciatic neuropathy. Herein, we report the case of a 66-year-old woman who experienced posterolateral right lower extremity radiating pain. We initially performed a lumbar transforaminal epidural steroid injection, but the pain persisted. Subsequently, hip MRI revealed sciatic neuropathy adjacent to the pedunculated portions of a uterine myoma. We then performed a sub-gluteal sciatic nerve block under ultrasound guidance, resulting in significant relief of her pain. In conclusion, hip MRI can be helpful for the differential diagnosis of sciatica, and ultrasound-guided sciatic nerve block can be considered an appropriate and effective treatment option.
Citations
, Jeong Hyun Yoo, Jeong Soo Suh, Chung Sik Rhee Ultrasound has been found to be accurate, reliable and noninvasive method in the measurement of spleen. The study was undertaken to obtain standard values of size in three dimensions and normal range of splenic volume by the use of splenic volumetric index(SVI) in normal korean adults.
We experienced 100 cases of abdominal ultrasonography of normal korean adults from May 1995 to August 1995.
1) The average size of spleen in adult male was 6.85±1.31cm in breadth, 4.93±1.27cm in thickness, 6.33±1.46cm in height ; in adult females, 6.61±1.23cm, 5.17±1.26cm, 6.33. 42cm, respectively ; total average, 6.73±1,27cm, 5.05±1.27cm, 6.33±1.39cm,respectively.
2) The average splenic volumetric index in adult male was 8.20±3.95; in adult females, 8.41±4.08 ; total average,8.31±4.00. There were no statistical differences of SVI and size between sex and age.
Although ultrasonography is less accurate than computed tomography, it is rapid and simple method for splenic measurement.
, Eun Cheol Chung, Jeong Soo Suh, Chung Sik Rhee Abdominal ultrasound for the health screen was performed in 4610 adults from the Jan. 1993 to Mar. 1995 at Ewha University Hospital Health Clinic. Gross abnormalities were noted in the 33.3% of examined persons. The most common finding was fatty liver(21.6%). And other abnormalities were renal cyst, gallbladder stone, hepatic cyst, and hepatic calcification in the order of frequency. It is concluded that abdominal ultrasound is an important screening modality in the adults.
, Hye-Young Choi, Chung Sik Rhee, Sun Hee Sung To evaluate pathologic findings of fibrocystic disease correlated with sonographic findings in the patients with solid lesion on ultrasonography.
Total 63 pathologically proven fibrocystic disease in 57 patients are retrospectively evaluated. On ultrasonography, the lesions were divided into solid and non-solid mass-like lesions. We analyzed the margin and echogenicity of solid mass-like lesions that were correlated with pathologic findings and also statistically analyzed Chi-square and Fisher's exact test.
Ultrasonogram of fibrocystic disease showed solid mass-like lesion in 73% and non solid mass-like lesion in 27%. Among the solid lesions, well-defined margin revealed in 72%, ill-defined margin in 28% and hypoechoic in 59%, isoechoic 41%. On the pathologic analysis, the solid and the non-solid mass-like lesion showed respectively : fibrous stroma in 56.5% and 53%, fibroadenomatous change in 50% and 12%, mixed stroma in 41% and 35.3%, cystic change in 37% and 70.6%, ductectasia in 28% and 58.8%, lobular hyperplasia in 26% and 12%, ductal hyperplasia 13% and 5.9%, and adenosis in 8.7% and 0%. The solid lesions showed more fibroadenomatous change and the difference between there was statistically significant(p=0.008).
The solid mass-like lesion, which represented as a well-defined isoechoic benign mass on ultrasonogram was more common than as expected, and this was due to the fibroadenomaous change on histopathology.
, Hee Ok Kim, Mi Young Park, Young Ju Kim, Jung Ja Ahn, Bock Hi Woo Neural tube defects are a heterogenous group of malformations resulting from failure of neural tube closure during early embryogenesis. Anencephaly is the commonest form of neural tube defect and results from failure of closure of the anterior portion of the neural tube. Anencephaly is characterized by absence of the cranium along with cerebral hemispheres that are rudimentary or absent and risk of recurrence after affected child is 2-3%. Periconceptual folic acid intake may decrease the incidence and recurrence of anencephaly.
Most often, anencephaly is discovered by conventional two-dimensional ultrasonography at the time of attempted biparietal diameter determination for fetal age in the second trimester. Two-dimensional transvaginal ultrasonography has a limitation in a motion of the transducer shaft due to narrow space of the vagina. It is sometimes impossible to obtain information of the whole brain and to miss the fetal CNS(central nervous system) anomalies. Recent advanced three-dimensional ultrasonography has remarkably improved not only surface rendering but also multiplanar analysis of internal structure.
Recently, we encountered one case of recurrent anencephaly that had occurred in a same pregnant woman and three-dimensional transvaginal ultrasonography enabled us to diagnose anencephaly at 113 weeks of gestation. We report this case with brief review of the literatures.
, Kyung Hee Kim To access the changes of cerebral blood flow velocity according to the time after surfactant administration, we prospectively studied in the Hyaline Membrane Disease using Doppler ultrasonography.
The patients were 26 infants. The mean gestational age was 3l4wks (range, 184 to 38wk). The ratio of male : female was 16 : 10, mean weight was 1.76±0.88Kg, Apgar score at 5min was 6.9, and type of delivery was C-section : vaginal delivery 19 : 4. Before and after, 10, 30min, 1, 6, l2hr, 1, 3, 5, 7days after surfactant administration, peak systolic and end-diastolic flow velocity(PSFV, EDFV) were estimated by Doppler method measuring MCA flow velocity. The Resistive index was calculated according to the mathematics. For the evaluation of the clinical status, systolic and diastolic systemic BP, PaO2, PaCO2, FiO2, pH, and respiratory rate(RR) were checked.
The cerebral blood flow velocity showed initial increase of PSFV just after synthetic surfactant administration, and the increased PSFV continued until the 30 minites and then decreased. PSFV returns to initial level at 6hr, and then increased again. The changes of EDFV was not significant. The changes of RI & PI were no significant changes. The effects of surfactant to the systemic BP had no significance. The changes of PaCO2 and PaO2 were not significant. FiO2 showed steady improvement. Initial tachypnea and acidosis progressively improved without clinical significance.
The administration of Surfactant in the HMD patients results in transient increase of cerebral blood flow velocity.
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