• Archives of Plastic Surgery
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• 제36권6호
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• pp.799-802
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• 2009

Purpose: Schwannoma is one of common neoplasm in the central and peripheral nervous systems. However, schwannoma of sciatic nerve is rare, especially large schwannoma arising in sciatic nerve is extremely rare. This is a report of our experience with large schwannoma arising in sciatic nerve with minimal neurologic symptoms. Methods: A 65 - year - old man presented with palpable mass in middle portion of posterior thigh. No definitive neurologic deficits were detected on physical examinations. CT and sonography showed well - defined mass with large dimension. The mass was excised and confirmed histologically as a schwannoma. In postoperative period, NCS and EMG were followed. Results: The patient complained of difficulty in dorsiflexion of ipsilateral ankle joint postoperatively. NCS and EMG obtained immediately and showed sciatic neuropathy. After 2 months postoperatively, NCS and EMG were followed and abnormal findings of previous NCS and EMG were not found. Dorsiflexion of ankle joint was improved to normal range of motion. Conclusion: We report a rare case of large schwannoma arising in sciatic nerve with no definitive neurologic symptoms.

• 대한치과의사협회지
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• 제53권4호
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• pp.238-248
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• 2015

Sleep related breathing disorders(SRBDs) are a group of diseases accompanied by difficulties in respiration and ventilation during sleep. Central sleep apnea, obstructive sleep apnea(OSA), sleep-related hypoventilation, and hypoxemia disorder are included in this disease entity. OSA is known to be the most common SRBDs and studies show its significant correlation with general health problems including hypertension, arrhythmia, diabetes, and metabolic syndrome. The diagnostic process of OSA is composed of physical examinations of the head and neck area and also the oral cavity. Radiologic studies including cephalography, CT, MRI, and fluoroscopy assist in identifying the site of obstruction. However, polysomnography(PSG) is still considered the gold standard for the diagnosis of OSA since it offers both qualitative and quantitative recording of the events during a whole night's sleep. The dentist who is trained in sleep medicine can easily identify patients with the risk of OSA starting from simple questions and screening questionnaires. Diagnosis is the first step to treatment and considering the high rate of under-diagnosis for OSA the dentist may play a substantial role in the diagnosis and treatment of OSA which will eventually lead to the well-being of the patient as a whole person. So the objective of this article is to assist dental professionals in gaining knowledge and insight of the diagnostic measures for OSA including PSG.

• Investigative Magnetic Resonance Imaging
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• 제23권3호
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• pp.276-278
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• 2019

The cisterna chyli, a dilated lymphatic sac in the retrocrural space, is usually located to the right of the aorta. We report a case of a left-sided cisterna chyli, which was incidentally detected on the radiologic examinations of a preoperative workup for cholangiocarcinoma. Computed tomography (CT) and magnetic resonance (MR) images revealed a cisterna chyli measuring 2.5 cm in length in the left retrocrural space. The dilated lumbar lymphatics joined with the cisterna chyli, which was continuous with the left-sided thoracic duct. To the best of our knowledge, this is the second antemortem case of a left-sided cisterna chyli in literature. The cisterna chyli can mimic retrocrural lymphadenopathy, solid tumor with cystic degeneration, abscess or hematoma. The left-sided cisterna chyli should be referred to as a structure so as to be cautious in surgical approach.

• Imaging Science in Dentistry
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• 제51권4호
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• pp.351-361
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• 2021

Purpose: The clivus is a region in the anterior section of the occipital bone that is commonly imaged on large-volume cone-beam computed tomography (CBCT). There have been several reports of incidental clivus variations and certain pathological entities that have been attributed to the variations. This study aimed to evaluate the effects of these variations within the scope of dentistry. Materials and Methods: Medical databases (PubMed, Scopus, and Web of Science) were searched using a controlled vocabulary (clival anomalies, cone-beam CT, canalis basilaris medianus, fossa navicularis magna, clival variation). The search was limited to English language, humans, and studies published in the last 25 years. The articles were exported into RefWorks^® and duplicates were removed. The remaining articles were screened and reviewed for supporting information on variations of the clivus on CBCT imaging. Results: Canalis basilaris medianus and fossa navicularis magna were the most common anomalies noted. Many of these variations were asymptomatic, with most patients unaware of the anomaly. In certain cases, associated pathologies ranged from developmental (Tornwaldt cyst), to acquired (recurrent meningitis). While no distinct pathognomonic aspects were noted, there were unique patterns of radiographic diagnosis and treatment modalities. Most patients had a normal course of follow-up. Conclusion: Interpretation of CBCT volumes is a skill every dentist must possess. When reviewing large-volume CBCT scans, the clinician should be able to distinguish pathology from normal anatomic variations within the skull base. The majority of clivus variations are asymptomatic and will remain undetected unless incidentally noted on radiographic examinations.

• Parasites, Hosts and Diseases
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• 제60권6호
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• pp.413-417
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• 2022

We retrospectively evaluated the clinical and imaging features of 6 patients with bone hydatid disease confirmed by surgery and pathological examination. Among the 6 patients, 2 were infected with Echinococcosis granulosus metacestode and 4 were infected with E. multilocularis metacestode. The 2 cases with cystic echinococcosis were diagnosed by computed tomographic (CT) examination, and other 4 cases were diagnosed by magnetic resonance (MR) imaging. On the initial evaluation, 1 case each was misdiagnosed as a giant cell tumor or neurogenic tumor, and 2 were misdiagnosed as tuberculosis. The imaging manifestations of bone hydatid disease are complex, but most common findings include expansive osteolytic bone destruction, which may be associated with sclerosing edges or dead bone formation, localized soft tissue masses, and vertebral lesions with wedge-shaped changes and spinal stenosis. Combining imaging findings with the patient's epidemiological history and immunological examinations is of great help in improving the diagnosis and differential diagnosis of bone hydatid disease.

• 한국임상수의학회지
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• 제41권1호
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• pp.43-48
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• 2024

A two-year-old, intact female Golden Retriever had previously been diagnosed with a portosystemic shunt (PSS) during an ultrasonographic examination at a local animal hospital. The serum biochemistry revealed elevated liver enzymes and bile acid levels. The abdominal radiographic examination revealed mild serosal detail loss and microhepatica, while abdominal ultrasonography revealed mild ascites and high-velocity flow to the caudal vena cava (CVC) suspected as a PSS. The gallbladder was not observed within the hepatic parenchyma during ultrasonography. Computed tomography (CT) revealed an absent gallbladder and dilation of the common bile duct (CBD). Dilations of the gastroduodenal, splenic, colic and renal veins were also observed. A dilated left phrenico-abdominal vein that entered the CVC was previously misinterpreted as a PSS on the ultrasound examination. Based on the imaging examinations, the dog was diagnosed with congenital gallbladder agenesis associated CBD dilation.

• 대한영상의학회지
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• 제81권2호
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• pp.436-441
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• 2020

폐에서 발생한 선섬유종은 드물게 발생하는 종양으로 이 양성 병변에 대해 발표된 보고는 매우 적다. 영상의학적으로 대부분의 이 병변은 단일 폐결절로 나타나며, 다발성은 극히 드물다. 저자는 71세 여자 환자에서, 전산화단층촬영 검사상 서로 다른 엽에 두 개의 결절로 보인 폐의 선섬유종에 대한 흔치 않은 증례를 보고하고자 한다. 폐의 선섬유종의 확실한 진단을 위해서는 조직병리학적 검사와 면역조직화학 검사가 필요하다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권5호
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• pp.361-366
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• 2024

Orthognathic surgery often requires intraoral orthodontic appliances that are fixed directly to the bone, which can complicate nasotracheal intubation if the devices protrude into the nasal cavity. This case report describes a 19-year-old man scheduled for elective orthognathic surgery who experienced recurrent cuff tears of the endotracheal tube during nasotracheal intubation due to protruding orthodontic screws in the palate. Despite initial attempts at nasotracheal intubation through the left nostril, the cuff of the 7.0 mm internal diameter (ID) Ring, Adair & Elwyn (RAE) tube repeatedly ruptured, with identical rupture patterns observed. Facial CT revealed that the orthodontic screws had protruded into both nasal cavities with significant visibility in the sagittal, coronal, and transverse views. Fiberoptic examination of the left nasal passage identified a firm protrusion below the inferior turbinate, corresponding to the location of the screw, which likely caused the cuff tears. Intubation was successfully performed via the right nostril during the fiberoptic examination. This case highlights the critical importance of evaluating intraoral corrective devices using comprehensive craniofacial imaging before anesthesia induction, as well as conducting fiberoptic examinations during intubation to avoid complications and ensure patient safety.

• 대한방사선기술학회지:방사선기술과학
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• 제32권4호
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• pp.453-460
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• 2009

슬라이스 두께(slice thickness)와 선속시준(beam collimation, BC)의 변화에 따른 CT gantry aperture 내의 선량 분포와 영상의 질을 알아보고자 하였다. CT장치로는 64-slice MDCT 스캐너(Brilliance 64, Philips, Cleveland, USA)를 사용하였다. 피사체가 없는 경우(air scan)의 선량측정을 위해 CT용 전리함을 gantry aperture내의 회전중심점(isocenter)과 12시, 3시, 6시, 9시 방향에서 회전중심점으로부터 5 cm 간격으로 30 cm까지 BC를 변화시키면서 각각 측정 하였다. 또한 5개의 구멍(팬텀의 중심과 12시, 3시, 6시, 9시 방향)으로 구성된 CT head and body dose phantom을 gantry aperture 내에 위치시키고 각 지점에서 선량을 측정하였다. Gantry aperture 내 피사체의 위치변화에 대한 영상의 노이즈를 비교하기 위해서 AAPM CT용 팬텀의 물통을 회전중심점과 12시 방향으로 5 cm와 10 cm 이동시킨 후 BC를 변화시키면서 스캔한 후 팬텀의 중심과 12시, 3시, 6시, 9시 방향의 지점에서 노이즈를 측정하였다. 이 중에서 몇 군데의 위치는 영상 영역에서 벗어나서 측정 할 수가 없었다. 이때 노이즈 측정을 위해서 영상재구성의 슬라이스 두께는 5 mm로 하였다. 측정한 결과 다음과 같은 결론을 얻었다: 첫째, CTDIw는 회전중심점으로부터 멀어질수록, BC가 넓어질수록 감소하였다. 둘째, BC의 넓이가 비슷한 경우의 CTDIw는 거의 유사한 값을 보였다. 즉, CTDIw는 검출기 배열의 수나 화소의 크기 보다는 전체적인 BC의 넓이에 의존하고 있음을 알 수 있었다. 셋째, air scan과 phantom scan 경우 모두에서 CTDIw는 BC가 증가될수록 감소하였다. 그러나 air scan의 경우보다 head phantom scan 시 약 30%, body phantom scan 시 약 52% 정도 CTDIw의 값이 감소하였다. 넷째, BC와 팬텀의 위치 변화에 따른 노이즈 값은 $2{\times}0.5\;mm$의 BC을 제외하고는 head phantom scan한 경우 3.9~5.9, body phantom scan한 경우 5.3~7.4로 나타나, BC와 팬텀의 위치변화에 따라서 큰 차이가 없었다. 따라서 피사체의 위치가 gantry aperture 내 SFOV(scan field of view)에 포함될 경우 회전중심점에 정확하게 위치시키지 않아도 영상의 질에는 많은 영향을 미치지 않는다는 것을 알 수 있었다.

• 대한한의학회지
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• 제34권3호
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• pp.69-85
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• 2013

Objectives: This study investigated the anti-osteoarthritic effects of Kyejiinsam-tang (hereinafter referred to KIT) on the monosodium iodoacetate (MIA)-induced osteoarthritis rats. Methods: Anti-oxidative effects of KIT were measured by scavenging activities of DPPH, reactive oxygen species (ROS) and nitric oxide (NO). Scavenging activities of anti-oxidation in lipopolysaccharide (LPS)-treated RAW 264.7 cells were also measured for inhibitory effects against the production of inflammatory mediators (tumor necrosis factor-${\alpha}$, interleukin-$1{\beta}$, interleukin-6). Osteoarthritis was induced in rats by injecting MIA in the knee joint. Rats were divided into a total of 4 groups (n=6). The normal group were not treated at all without inducing osteoarthritis whereas the control group were induced for osteoarthritis by MIA and oral medicated physiological saline per day. The positive comparison group was injected with MIA and after 7 days, 2 mg/kg of Indomethacin. The experimental group was injected with MIA and after 7 days was medicated with 34 mg/kg of KIT. Indomethacin and KIT were orally-medicated for each substance a total of 4 weeks, once per day. Weight-bearing on hind legs was measured every week after MIA injection. At the end of the experiment (5 weeks after MIA injection), micro CT (computed tomography)-arthrography and histopathological examinations on the articular structures of knee joint were performed. The effect on inflammatory cytokines and immunological cells in synovial fluid was measured. Volume of cartilage was measured by micro CT-arthrography. Injury to synovial tissue was measured by H & E (hematoxylin and eosin), Safranin-O immunofluorescence. Results: 1. Cytotoxicity against hFCs was insignificant. 2. KIT showed the potent full term for DPPH. 1. NO was significantly reduced by KIT (at 100, $200{\mu}g/m{\ell}$) and ROS was also reduced, but not significantly, by KIT (at $200{\mu}g/m{\ell}$). 2. IL-6 and IL-$1{\beta}$ were significantly reduced by KIT (at 100, $200{\mu}g/m{\ell}$) and TNF-${\alpha}$ was also reduced, but not significantly, by KIT (at $200{\mu}g/m{\ell}$). 1. In hind legs weight-bearing measurement, level of weight increased. 2. Functions of liver and kidney were not affected. 3. IL-$1{\beta}$ was significantly reduced and TNF-${\alpha}$, IL-6 were also reduced but not significantly. 4. PGE2 (prostaglandin E2), LTB4 (leukotriene B4) were significantly reduced in the KIT group. 5. MMP-9 (matrix metalloproteinase-9), TIMP-1 (tissue inhibitor of metalloproteinases-1) and Osteocalcin were significantly reduced in the KIT group. 6. Destruction of cartilage on micro CT arthrography was reduced but had no significant differences. 7. Histopathologically, injury to synovial membrane of the KIT group was decreased and proteoglycan content of KIT group was increased. Conclusions: According to this study, Kyejiinsam-tang has inhibiting effect on the progression of arthritis in MIA-induced osteoarthritis rat. Kyejiinsam-tang has anti-oxidants and anti-inflammation effects, and is related to inhibiting the activity of inflammatory cytokine and injury of volume in cartilage.