• Title/Summary/Keyword: CT/MRI

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Cerebral Dural Sinus Thrombosis - Case Report - (뇌경막 정맥동 혈전증 - 증례보고 -)

  • Han, Young-Min;Lee, Jong-Phil;Hwang, Hyung-Sik;Lim, Dae-Chul;Song, Joon-Ho;Ahn, Myung-Su
    • Journal of Korean Neurosurgical Society
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    • v.30 no.3
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    • pp.389-394
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    • 2001
  • Cerebral dural sinus thrombosis(CDST) has been described as a rare disease with a variety of patho-etiological factors. The diagnosis of CDST is difficult due to various symptoms and signs, none of which is specific to CDST. But timely diagosis is critical for effective management. The introduction and widespread use of computed tomography(CT), magnetic resonance imaging(MRI) and cerebral angiography made early diagnosis of CDST possible. In particular, MR venography is the most useful tool for establishing a correct diagnosis quickly. In early literature, mortality ranked between 30% and 50% but in more recent series it is between 5.5% and 30%. With the advent of diagnostic and therapeutic tools, early diagnosis and proper management has made the prognosis better. The appropriate therapy for CDST, however, has been the subject of much cortroversy. Individual variations of the venous system and collateral vessels are key factors to decide the proper treatment. In this report, we present two cases with symptomatic CDST treated without open surgical or direct endovascular interventions with good outcome.

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Expression of Vascular Endothelial Growth Factor and Peritumoral Brain Edema in Intracranial Meningiomas (수막종에서 혈관내피성장인자의 발현과 종양주변부 부종)

  • Kim, Tae Young;Park, Jong Tae;Han, Weon Cheol;Moon, Seong Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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    • pp.1222-1227
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    • 2000
  • Objective : Vascular endothelial growth factor(VEGF), an endothelial cell specific cytokine, is a potent angiogenic growth factor implicated in the tumor angiogenesis and increases vascular permeability dramatically. Peritumoral brain edema(PTBE) occurs in 40-60% of meningiomas. Many causative factors have been investigated, but the mechanism of PTBE associate with meningioma is unclear. VEGF has been implicated as one of the causative factors of PTBE. This study was designed to determine whether the extent of VEGF expression is correlated with degree of PTBE in meningiomas. Methods : Meningioma tissue samples from 40 patients(7 men and 33 women, mean age $53{\pm}13years$) who underwent surgery were examined retrospectively for the expression of VEGF immunohistochemically. The extent of PTBE was estimated by using preoperative CT or MRI as an edema index(EI). In addition to VEGF, several causative factors including tumor size, location, histologic type, microvasculature(CD31) were compared with EI. Results : Twenty-six meningiomas demonstrated PTBE, and the other 14 did not. Of the 40 patients of meningiomas, 28 were positive(17 were 1+ and 11 were 2+) for VEGF. The EI increased significantly just as VEGF was strongly expressed(p=0.006). Microvascular proliferation was also closely correlated with the extent of peritumoral brain edema(p<0.05). Conclusion : These data suggest that VEGF expression and microvascular proliferation are closely correlated with PTBE in meningioma.

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Osteoplasty in Acute Vertebral Burst Fractures

  • Park, Sang-Kyu;Bak, Koang-Hum;Cheong, Jin-Hwan;Kim, Jae-Min;Kim, Choong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.40 no.2
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    • pp.90-94
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    • 2006
  • Objective : Acute vertebral burst fractures warrant extensive fixation and fusion on the spine. Osteoplasty [vertebroplasty with high density resin without vertebral expansion] has been used to treat osteoporotic vertebral compression fractures. We report our experiences with osteoplasty in acute vertebral burst fractures. Methods : Twenty-eight cases of acute vertebral burst fracture were operated with osteoplasty. Eighteen patients had osteoporosis concurrently. Preoperative MRI was performed in all cases to find fracture level and to evaluate the severity of injury. Preoperative CT revealed burst fracture in the series. The patients with severe ligament injury or spinal canal compromise were excluded from indication. Osteoplasty was performed under local anesthesia and high density polymethylmethacrylate[PMMA] was injected carefully avoiding cement leakage into spinal canal. The procedure was performed unilaterally in 21 cases and bilaterally in 7 cases. The patients were allowed to ambulate right after surgery. Most patients discharged within 5 days and followed up at least 6 months. Results : There were 12 men and 16 women with average age of 45.3[28-82]. Five patients had 2 level fractures and 2 patients had 3 level fractures. The average injection volume was 5.6cc per level Average VAS [Visual Analogue Scale] improved 26mm after surgery. The immediate postoperative X-ray showed 2 cases of filler spillage into spinal canal and 4 cases of leakage into the retroperitoneal space. One patient with intraspinal leakage was underwent the laminectomy to remove the resin. Conclusion : Osteoplasty is a safe and new treatment option in the burst fractures. Osteoplasty with minimally invasive technique reduced the hospital stay and recovery time in vertebral fracture patients.

Region-Based 3D Image Registration Technique for TKR (전슬관절치환술을 위한 3차원 영역기반 영상정합 기술)

  • Key, J.H.;Seo, D.C.;Park, H.S.;Youn, I.C.;Lee, M.K.;Yoo, S.K.;Choi, K.W.
    • Journal of Biomedical Engineering Research
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    • v.27 no.6
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    • pp.392-401
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    • 2006
  • Image Guided Surgery (IGS) system which has variously tried in medical engineering fields is able to give a surgeon objective information of operation process like decision making and surgical planning. This information is displayed through 3D images which are acquired from image modalities like CT and MRI for pre-operation. The technique of image registration is necessary to construct IGS system. Image registration means that 3D model and the object operated by a surgeon are matched on the common frame. Major techniques of registration in IGS system have been used by recognizing fiducial markers placed on the object. However, this method has been criticized due to additional trauma, its invasive protocol inserting fiducial markers in patient's bone and generating noise data when 2D slice images are acquired by image modality because many markers are made of metal. Therefore, this paper developed shape-based registration technique to improve the limitation of fiducial marker based IGS system. Iterative Closest Points (ICP) algorithm was used to match corresponding points and quaternion based rotation and translation transformation using closed form solution applied to find the optimized cost function of transformation. we assumed that this algorithm were used in Total Knee replacement (TKR) operation. Accordingly, we have developed region-based 3D registration technique based on anatomical landmarks and this registration algorithm was evaluated in a femur model. It was found that region-based algorithm can improve the accuracy in 3D registration.

Development of Portable Gamma Probe and Its Basic Performance Test (이동형 감마프로브 개발과 기본성능 평가)

  • Kim, H.J.;Kwark, C.;Choi, Y.;Yang, M.K.;Bong, J.K.;Lee, S.C.
    • Proceedings of the KOSOMBE Conference
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    • v.1997 no.05
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    • pp.216-219
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    • 1997
  • We are developing a portable multipurpose gamma counting and imaging probe that will be useful for many applications in nuclear medicine including radioimmunoguided surgery in the detection and treatment of malignant tumors. Any diagnostic information provided by CT, MRI, PET, SPECT or gamma camera imaging prior to surgery obviously is very important, but current techniques are limited in many instances. To overcome some of these limitations, the portable multipurpose gamma probe is being developed. The gamma probe consists of NaI(Tl) crystal with 1" dia $\times$ 0.5" thick and singlechannel photomultiplier tube (SC-PMT) for counting, and 3" dia $\times$ 0.375" and multichannel photomultiplier tube (MC-PMT) for imaging, nuclear instrument module (NIM), position circuits, interface, and PC. The energy resolution using Tc-99m was measured as 14% and the spatial resolution using 3mm dia green LED was measured as 2.9mm. These priliminary results indicate that the currently developing probe is very promising and could be very useful for many applications in nuclear medicine.

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A Study on Stereo Visualization of the X-ray Scanned Image Based on Dual-line Sensors (듀얼센서 기반 X-선 검색영상 스테레오 가시화 연구)

  • Lee, Nam-Ho;Hwang, Young-Gwan;Park, Jong-Won;Lim, Yong-Gon
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.14 no.9
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    • pp.2083-2090
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    • 2010
  • This paper presents a 3-D visualization technique using stereo radioactive images to provide efficient inspection of fast moving cargo objects. The proposed technique can be used for such objects which CT or MRI cannot inspect due to restricted scan environment. Stereo radioactive images are acquired from a specially designed equipment which consists of a X-ray source, linear radioactive sensors, and a moving stage. Two radioactive sensors are installed so that rectified stereo X-ray images of objects are acquired. Using the stereo X-ray images, we run a matching algorithm to find the correspondences between the images and reconstruct 3-D shapes of real objects. The objects are put in a parallelepiped box to simulate cargo inspection. Three real objects are tested and reconstructed. Due to the inherent ambiguity in the stereo X-ray images, we reconstruct 3-D shapes of the edges of the objects. The experimental results show the proposed technique can provide efficient visualization for cargo inspection.

Clinical Study of Stroke Type (뇌졸중(腦卒中) 환자(患者) 형태(形態)에 관(關)한 임상연구(臨床硏究))

  • Youn, Hyoun-min;Ahn, Chang-beohm;Song, Choon-ho;Son, In-seok;Jang, Kyung-jeon
    • Journal of Acupuncture Research
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    • v.20 no.2
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    • pp.29-41
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    • 2003
  • Clinical observation was made on 52 cases of Stroke that were confined through brain CT, MRI scan. The Stroke cases wee classified into the following kinds cerebral infarction, cerebral hemorrhage, cerebellar or brain stem infarction, cerebellar or brain stem hemorrhage. And among the 52 cases of Stroke cerebral infarction was noticed in 75.00%, cerebral hemorrhage in 11.54%, cerebellar or brain stem infarction in 9.52%, cerebellar or brain stem hemorrhage in 3.85%. The ratio between males and females was 1.74:1 in the whole groups of Stroke and most cases were over 60 of age. As the time of hospitalization, most patients hospitalized from 1 day after stroke to 7 days after stroke. And as the course of hospitalization, most patients hospitalized first. Among the preceding disease at the onset of Stroke hypertention was noted in 32.69%, and deabetes mellitus or heart problem was noted frequently(15.39%). Electrocardiography findings were as follows: The normal was noted in 53.85%, the abnormal in 46.15%. And as the abnormal, left ventricular hypertrophy was noted in 17.54%. The predisposing factors or conditions at the onset of brain infarction were usually initiated during the time of sleeping and those of brain hemorrhage chiefly during the time of exercising like overwork or walking etc. It was noted that smoking a pack of cigarette showed highest disease rate(33.33%) among the average of smoking amount of one day in case of man. Prior to attack, the most chiefly complain was dyspnea or discomfort on chest region. And 30.70% of patients had no previous sign. There were a large number of recurrent cases. The first attack was noted in 71.15%, the 2nd attack in 23.08%, the 3rd attack in 5.77%.

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Effectiveness of Bee-venom Acpuncture and Ouhyul Herbal Acpuncture in Herniation of Nucleus Pulposus-comparison with Acpuncture Therapy Only (요각통(腰脚痛)에 대한 단침치료군(單鍼治療群), 봉약침(蜂藥鍼) 병행치료군(竝行治療群), 중성어혈약침(中性瘀血藥鍼) 병행치료군(竝行治療群)의 비교연구)

  • Lee, Sung-Hwan;Kang, Min-Wan;Lee, Hyun;Lee, So-Yol
    • Journal of Acupuncture Research
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    • v.24 no.5
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    • pp.197-205
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    • 2007
  • Objectives : Herniation of Nucleus Pulposus(HNP) of Lumbar is the most important that causes low back pain. The aim of this study is to compare several therapies about Lumbar spine Hearniated Nucleus Pulposus in oriental Medecine which are Bee-venom Acpuncture and Ouhyul Herbal Acpuncture. Methods: Subjects of this research were 60 inpatients complaining Herniation of Nucleus Pulposus, and who were diagnosed as bulging disc, disc protrusion or extrusion with CT & MRI. 20 patients in each, 3 groups; Acpuncture therapy only, Bee-venom Acpuncture, and Ouhyul Herbal Acpuncture, were divided and the conclusions for treatment are as follows. Results : 1. Regarding alleviation of pain by VAS, Ouhyul Herbal Acpuncture Group III showed significant decrease of VAS in the early period of admission(5days), while Bee-venom Acpuncture Group II showed higher score of VAS compared to Acpuncture therapy only Group I. 2. On contrary, in the latter period of admission($5{\sim}9days$), Bee-venom Acpuncture Group II showed significantly higher rate of improvement than the other groups. 3. On the 9th admission day, Bee-venom Acpuncture Group II and Ouhyul Herbal Acpuncture Group III showed higher improvement than Acpuncture therapy only Group I. Between group II and III, Group II showed higher improvement rate. Conclusions : In this study, there were different effects among three groups according to period of treatment. Further study on various traatment for Herniation of Nucleus Pulposus required.

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Treatment of Salivary Duct Carcinoma: A Case Report (타액선관 상피암의 치험례)

  • Moon, Suk Ho;Yoo, Gyeol;Choi, Yun Seok;Lim, Jin Soo;Han, Ki Taik
    • Archives of Craniofacial Surgery
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    • v.9 no.1
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    • pp.23-26
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    • 2008
  • Salivary duct carcinoma is a high-grade adenocarcinoma arising from the ductal epithelium and has very low prevalence. We report a case of salivary duct carcinoma in high risk group with satisfactory result. A 65-year-old male was referred to our clinic complaining of mass on Rt. cheek. Preoperative CT and MRI shows $2.0{\times}1.9cm$ sized multilobulated, cystic mass on the superficial lobe of Rt. parotid gland and multiple lymph node enlargement thorough the Rt. internal jugular chain. Total parotidectomy and modified radical neck dissection with adjuvant radiation therapy was performed. Pathologic result was salivary duct carcinoma and resection margin was free. Postoperative radiation therapy with 6400 cGy($200cGy{\times}12fx$) was performed. During the 24-months of follow up periods, recurrence or complications associated with operation and radiation therapy was not observed. Salivary duct carcinoma is rare disease with very poor prognosis. Lymph node metastasis is commonly accompanied at the time of diagnosis. Distant metastasis is the most common cause of death. Total parotidectomy, radical neck disssection and adjuvant radiation therapy can be the appropriate modality for the control of the salivary duct carcinoma especially in high risk group.

A clinical study of vascular dementia in stroke patients (중풍환자(中風患者)의 혈관성치매에 대한 임상적(臨床的) 관찰(觀察))

  • Kim Won-Chan;Kim Young-Suk;Moon Sang-Kwan;Ko Chang-Nam;Cho Ki-Ho;Bae Hyung-Sup;Lee Kyung-Sup;Park Jung-Mi
    • The Journal of Internal Korean Medicine
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    • v.19 no.2
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    • pp.50-59
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    • 1998
  • Background : Vascular dementia occurs mainly due to cerebral vascular disease. So we performed this clinical study to investigate the incidence and characteristics of vascular dementia in stroke patients. Methods : This study was performed on the patients hospitalized from April 1, 1998 to August 31, 1998 at the department of circulatory internal medicine, hospital of Oriental medicine, Kyung-Hee University, and diagnosed cerebral infarction or hemorrhage by Brain CT or MRI. we devided the patients into two groups; vascular dementia group and non dementia group according to MMSE-K(Mini Mental State Examination Korean version), Hasegawa dementia scale. Patients were diagnosed dementia using DSM-IV. We compared general characteristics, stoke types and laboratory findings between the two groups and investigated the correlationship between MMSE-K and Hasegawa dementia scale. Results : Results showed that the incidence of vascular dementia was about 27.8% in stroke patients. The greater number of subjects with dementia were women in the lower educational classes and had lower MBI(Moderfied Bathel Index) scores. Vascular dementia were more common in patients with large brain lesion size($>20cm^3$). There was a positive correlationship between Hasegawa scores and MMSE-K.

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