• Korean Journal of Radiology
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• 제22권11호
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• pp.1850-1857
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• 2021

Objective: The purpose of this study was to assess whether a deep learning (DL) algorithm could enable simultaneous noise reduction and edge sharpening in low-dose lumbar spine CT. Materials and Methods: This retrospective study included 52 patients (26 male and 26 female; median age, 60.5 years) who had undergone CT-guided lumbar bone biopsy between October 2015 and April 2020. Initial 100-mAs survey images and 50-mAs intraprocedural images were reconstructed by filtered back projection. Denoising was performed using a vendor-agnostic DL model (ClariCT.AI^TM, ClariPI) for the 50-mAS images, and the 50-mAs, denoised 50-mAs, and 100-mAs CT images were compared. Noise, signal-to-noise ratio (SNR), and edge rise distance (ERD) for image sharpness were measured. The data were summarized as the mean ± standard deviation for these parameters. Two musculoskeletal radiologists assessed the visibility of the normal anatomical structures. Results: Noise was lower in the denoised 50-mAs images (36.38 ± 7.03 Hounsfield unit [HU]) than the 50-mAs (93.33 ± 25.36 HU) and 100-mAs (63.33 ± 16.09 HU) images (p < 0.001). The SNRs for the images in descending order were as follows: denoised 50-mAs (1.46 ± 0.54), 100-mAs (0.99 ± 0.34), and 50-mAs (0.58 ± 0.18) images (p < 0.001). The denoised 50-mAs images had better edge sharpness than the 100-mAs images at the vertebral body (ERD; 0.94 ± 0.2 mm vs. 1.05 ± 0.24 mm, p = 0.036) and the psoas (ERD; 0.42 ± 0.09 mm vs. 0.50 ± 0.12 mm, p = 0.002). The denoised 50-mAs images significantly improved the visualization of the normal anatomical structures (p < 0.001). Conclusion: DL-based reconstruction may enable simultaneous noise reduction and improvement in image quality with the preservation of edge sharpness on low-dose lumbar spine CT. Investigations on further radiation dose reduction and the clinical applicability of this technique are warranted.

• Applied Microscopy
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• 제36권3호
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• pp.183-194
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• 2006

동양의학 이론의 주요 관심사인 경락의 연구에 있어 생체 내 신호전달 체계와 해부학적 실체에 대한 단서를 확인하기 위하여 본 실험을 수행하였다. 1960년대 이루어졌던 봉한학설의 이론과 문헌을 근거로 하여 토끼의 복막에 존재하는 봉한관으로 생각되는 반투명의 회백색의 탄성이 있는 섬유상 구조물을 분리하여 조직학적으로 관찰하였다. 각 조직 샘플은 봉한관 확인을 위하여 hematoxylin eosin과 Masson's trichrome 염색, 교원섬유는 Van Gieson's 염색, 신경은 Kluver Barrera's luxol fast blul 염색을 하여 비교함으로써 구성성분에 대한 분석을 실시하였다. 광학현미경상에서 관찰된 조직들은 교원섬유와 신경으로 구성된 집합체였으며 다발의 형태를 이루고 있었고, 여러 개의 myoid spindle형태의 세포들이 종으로 배열되어 있었다. 이러한 세포들은 신경의 슈반세포이며 봉한관의 myoid형태의 세포들과 같은 소견이었다. 같은 부위를 전자현미경으로 관찰한 결과 잘 배열된 교원섬유와 신경을 관찰할 수 있었으며 신경다발 사이로 교원섬유가 둘러싸고 있었다. 이상의 결과를 종합해 보면 복막에 존재하는 봉한관은 교원섬유와 어우러진 신경임을 확인할 수 있었고 신경과 어우러져 존재하는 교원섬유의 절연성과, 침의 치료에 있어 교원섬유가 주위의 신경과의 신호전달 체계에 영향을 미치는 점을 고려하여 볼 때 교원섬유와 신경 그리고 혈관의 유기적인 관계 속에서 교원섬유의 새로운 역할 규명에 대한 연구가 필요할 것으로 사료된다.

• Imaging Science in Dentistry
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• 제31권4호
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• pp.209-214
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• 2001

Purpose: To investigate the ability of double TMJ view by multifunctional panorama to view the bony components and the space of the temporomandibular joint. Materials and Methods: Ten dry skulls fitted with resin shims over the articular surface of the condyle were used to reproduce the temporomandibular joint space. Fine metal wires were attached to the three portions of contours of the condylar head and the articular eminence. With 10 dry skulls and 20 cases having TMJ dysfunction, double TMJ views by multifunctional panorama (Planmeca 2002 Proline CC) and transcranial views were taken, analyzed from the anatomical view point, and compared statistically in view of the widths of the posterior joint space and the condylar head. Results: In double TMJ view, the supero-anterior part of the condyle represented the lateral 1/3, the most superior part represented center portion, and the posterior part medial l/3 of the condyle. In maximum mouth opening, no other structures were superimposed with the condyle in double TMJ view. In double TMJ view, petrous bone was moderately superimposed with the superior part of the condyle and the posterior increment of angle exposure made wider the images of the articular eminence and the condyle. The tendency of reduction in the posterior joint space appeared in the side of TMJ dysfunction compared with the normal side. The posterior joint spaces in double TMJ view were statistically wider (p<0.05) than those in transcranial view. The correlation coefficient was 0.5179 between the widths of the posterior joint spaces in two radiographic views. Conclusions: Double TMJ view can be substituted for transcranial view in evaluating the TMJ dysfunction.

• 동의생리병리학회지
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• 제28권4호
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• pp.365-370
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• 2014

The intrinsic concepts of the three yin and three yang diseases in is unclear yet in spite of considerable controversy. In order to answer these problems, the structures of pathological transmission and anatomical terms used in the text were analyzed first. On these structural bases, the theoretical background and differential therapeutic principles of three yin and three yang disease classification. The organic structures frequently used in the text were heart, stomach, pancreas, blood chamber and urinary bladder, and the important regions in the transmission were chest, flank, epigastrium, abdomen, hypogastrium, groin on the other hand. When a host is invaded by extrinsic pathogen, an affinity is formed between the two based on the similarity of epidermal density condition and nutrient-defense features and existing disorders in the body. And then the symptoms show in 3 stages with 6 patterns in the general infective diseases. The initial stage is the period that the syndrome is limited in the external flesh area, and it mainly corresponds with taiyang bing besides the other exterior patterns of 3 yang and 2 yin bing. The middle stage is to the climax after the end of initial stage and it corresponds with mainly yangming bing including shaoyang and taiyin bing. In the terminal stage, the host gradually falls into exhaustive step or recovery phase, corresponding with shaoyin and jueyin bing. Conclusively, these dual meanings of three yang and yin should be a first guide and principle of treatment against various infective diseases.

• Journal of Korean Neurosurgical Society
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• 제52권4호
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• pp.300-305
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• 2012

Objective : The purpose of this study is to elucidate the anatomic relationships between the uncinate process and surrounding neurovascular structures to prevent possible complications in anterior cervical surgery. Methods : Twenty-eight formalin-fixed cervical spines were removed from adult cadavers and were studied. The authors investigated the morphometric relationships between the uncinate process, vertebral artery and adjacent nerve roots. Results : The height of the uncinate process was 5.6-7.5 mm and the width was 5.8-8.0 mm. The angle between the posterior tip of the uncinate process and vertebral artery was $32.2-42.4^{\circ}$. The distance from the upper tip of the uncinate process to the vertebral body immediately above was 2.1-3.3 mm, and this distance was narrowest at the fifth cervical vertebrae. The distance from the posterior tip of the uncinate process to the nerve root was 1.3-2.0 mm. The distance from the uncinate process to the vertebral artery was measured at three different points of the uncinate process : upper-posterior tip, lateral wall and the most antero-medial point of the uncinate process, and the distances were 3.6-6.1 mm, 1.7-2.8 mm, and 4.2-5.7 mm, respectively. The distance from the uncinate process tip to the vertebral artery and the angle between the uncinate process tip and vertebral artery were significantly different between the right and left side. Conclusion : These data provide guidelines for anterior cervical surgery, and will aid in reducing neurovascular injury during anterior cervical surgery, especially in anterior microforaminotomy.

• Journal of Korean Neurosurgical Society
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• 제29권10호
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• pp.1396-1401
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• 2000

Although direct surgical treatment of the lesion in the pons may cause severe neurologic morbidity, safe route to minimize injuries of the important structures in the pons should be considered. The authors operated four cases of intrapontine lesions via safe approach route without causing severe neurologic complications. Two cases were intrapontine tumors and other two were intrapontine hematoma. An anaplastic astrocytoma($3{\times}3{\times}3cm$) located bilaterally in the pons was approached via midline of the median sulcus, and a metastatic tumor($1.5{\times}1.5{\times}1.5cm$) located at the left posterolateral aspect in the upper pons was approached via suprafacial space. Two cases of hematoma were evacuated via median sulcus, and supra- and infrafacial spaces. Preoperatively, quadriplegia, swallowing difficulty, diplopia, speech disturbance, and nystagmus were noted in a patient with an anaplastic astrocytoma. A patient with metastatic tumor showed mild right hemiparesis, right hemisensory disturbance, diplopia, and dizziness. Two patients with hematoma in the pons were comatous, and had contracted, fixed pupils. Postoperatively, a patient with an anaplastic astrocytoma recovered and a patient with a metastatic tumor showed temporary hemifacial palsy. Mental status was fully recovered normal even though facial palsy, diplopia, severe ataxia, dizziness, and tremor persisted in both patients with pontine hematoma. Careful operation based on the anatomical knowledge of the floor of the 4th ventricle is of prime importance in appraoching to the intrapontine lesion with minimal injuries of the eloquent structures during surgery.

• 대한정형외과 초음파학회지
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• 제3권1호
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• pp.32-37
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• 2010

정형외과 영역에서 초음파를 이용한 진단과 치료가 광범위하게 사용되고 있다. 특히 족부 및 족관절에서의 초음파를 이용한 진단 족부 및 족관절의 해부학적 특성상 매우 유리한 것으로 알려져 있다. 족부 및 족관절에 발생하는 다양한 질환의 원인과 치료를 시행하기 위해서는 족부 및 족관절의 해부학적, 생역학적 특징을 잘 이해하여야 한다. 족부 및 족관절은 총 28개의 뼈와 많은 수의 인대, 건으로 이루어져 있으며 이들간의 유기적인 결합을 통해 신체를 지탱하는 정적 기능과 걷는 동적 기능을 동시에 수행할 수 있는 복잡한 구조 물이다. 그리고 작은 공간에 여러 구조물이 밀집되어 있어서 질환이 있는 부위의 정확한 이학적 검사가 요구된다. 그러므로 해부학적, 생역학적 지식을 바탕으로 이학적 검사를 체계적으로 시행함으로써 초음파를 이용한 진단 및 치료에 정확성을 기할 수 있다.

• 한국임상수의학회지
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• 제16권2호
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• pp.300-308
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• 1999

Arthroscopy is a valuable diagnostic and operative tool in equine and human orthopedics. The arthroscope is a difficult instrument to use and requires patience, practice, and persistence in order to obtain good results. This technique was found to be less traumatic than arthrotomy, invasiveness, rapid recovery and the feasibility of surgically correcting many arthropathies. The use of the arthroscope in the dog provides a new dimension in the study and diagnosis of joint derangements. The purpose of this report is to introduce the use of the arthroscope in the dog-more specifically, in the stifle of the dog. A diameter 2.7 mm fore-oblique viewing arthroscope, cold light source, video and video printer are used. With the fore-oblique viewing type it is possible to view directly as well as slightly to the side and the range of viewing can be increased by rotating the arthroscope around the object The scope is connected with a cold light source by means of a fiber-optic light guide. The stifle joint was flexed to 20~30$^{\circ}$. The joint were lavaged with lactated Ringer's solution during arthroscopic examination. Arthroscopy of the stifle was performed prior to arthrotomy in 1 dead dog and 4 healthy dogs, and other 3 dogs was performed only arthroscopic examination. In this study only the conventional approaches were used and in most cases it was possible to view all the intra-articular structures via the lateral infrapatellar approach. In the stifle joint, endoscopic observation was performed to find lateral femoral condyle, patella, medial femoral condyle, trochlear groove, tibia, fat, cranial cruciate ligament, caudal cruciate ligament lateral meniscus, tendon of long digital extensor muscle, medial meniscus, and medial collateral ligament Post-arthroscopic examination, the lameness had disappeared within 12~24 hours. Pain and swelling in the stifle joint had disappeared within 24~36 hours. Post-arthroscopic secondary infection was never encountered in the dogs. In conclusion, arthroscopic insertion technique in canine stifle joint using a diameter 2.7 mm 30$^{\circ}$ arthroscope was established and arthroscopical views of all anatomical structures in the normal stilfe joint were obtained through lateral infrapatellar portal.

• Journal of Korean Neurosurgical Society
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• 제47권3호
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• pp.174-179
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• 2010

Objective : Cricothyrotomy and tracheostomy are performed by physicians in various disciplines. It is important to know the comprehensive anatomy of the laryngotracheal region. Hemorrhage, esophageal injury, recurrent laryngeal nerve injury, pneumothorax, hemothorax, false passage of the tube and tracheal stenosis after decannulation are well known complications of the cricothyrotomy and tracheostomy. Cricothyrotomy and tracheostomy should be performed without complications and as quickly as possible with regards the patients' clinical condition. Methods : A total of 40 cadaver necks were dissected in this study. The trachea and larynx and the relationship between the trachea and larynx and the surrounding structures was investigated. The tracheal cartilages and annular ligaments were counted and the relationship between tracheal cartilages and the thyroid gland and vascular structures was investigated. We performed cricothyrotomy and tracheostomy in eleven cadavers while simulating intensive care unit conditions to determine the duration of those procedures. Results : There were 11 tracheal cartilages and 10 annular ligaments between the cricoid cartilage and sternal notch. The average length of trachea between the cricoid cartilage and the suprasternal notch was 6.9 to 8.2 cm. The cricothyroid muscle and cricothyroid ligament were observed and dissected and no vital anatomic structure detected. The average length and width of the cricothyroid ligament was 8 to 12 mm and 8 to 10 mm, respectively. There was a statistically significant difference between the surgical time required for cricothyrotomy and tracheostomy (p < 0.0001). Conclusion : Tracheostomy and cricothyrotomy have a low complication rate if the person performing the procedure has thorough knowledge of the neck anatomy. The choice of tracheostomy or cricothyrotomy to establish an airway depends on the patients' clinical condition, for instance; cricothyrotomy should be preferred in patients with cervicothoracal injury or dislocation who suffer from respiratory dysfunction. Furthermore; if a patient is under risk of hypoxia or anoxia due to a difficult airway, cricothyrotomy should be preferred rather than tracheostomy.

• Clinics in Shoulder and Elbow
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• 제21권3호
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• pp.113-119
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• 2018

Background: This study was undertaken to evaluate the positional relationship between planes of the glenoid component (the scapular plane and the perpendicular plane to the glenoid) and its surrounding structures. Methods: Computed tomography (CT) images of both shoulders of 100 patients were evaluated using the 3-dimensional CT reconstruction program ($Aquarius^{(R)}$; TeraRecon). We determined the most lateral scapular bony structure of the scapular plane and measured the shortest distance between the anterolateral corner of the acromion and the scapular plane. The distance between the scapular plane and the midpoint of the line connecting the posterolateral corner of acromion and the anterior tip of the coracoid process (fulcrum axis) was also evaluated. The perpendicular plane was then adjusted to the glenoid and the same values were re-assessed. Results: The acromion was the most lateral scapular structure of scapular plane and perpendicular plane to the glenoid. The average distance from the anterolateral corner of the acromion to the scapular plane was $10.44{\pm}5.11mm$, and to the plane perpendicular to the glenoid was $9.55{\pm}5.13mm$. The midpoint of fulcrum axis was positioned towards the acromion and was measured at $3.90{\pm}3.21mm$ from the scapular plane and at $3.84{\pm}3.17mm$ from the perpendicular plane to the glenoid. Conclusions: Our data indicates that the relationship between the perpendicular plane to the glenoid plane and its surrounding structures is reliable and can be used as guidelines during glenoid component insertion (level of evidence: Level IV, case series, treatment study).