• Title/Summary/Keyword: CT Scans

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Reduced Regional Cerebral Blood Flow in Patients with Traumatic Brain Injury Who Had No Structural Abnormalities on Magnetic Resonance Imaging : A Quantitative Evaluation of Tc-99m-ECD SPECT Findings (정상 MRI 소견을 보이는 외상성 뇌손상 환자에서 국소뇌혈류량의 이상)

  • Kim, Nam-Hee;Chung, Young-Ki
    • Korean Journal of Biological Psychiatry
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    • v.9 no.2
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    • pp.152-158
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    • 2002
  • Background & Purpose:Neuropsychological disorders after traumatic brain injury(TBI) are poorly correlated with structural lesions detected by structural neuroimaging techniques such as computed tomography(CT) scan or magnetic resonance imaging(MRI). It is well known that patients with TBI have cognitive and behavioral disorders even in the absence of structural lesions of the brain. This study investigated whether there are abnormalities of regional cerebral blood flow(rCBF) in TBI patients without structural abnormality on MRI, using technetium 99m ethyl cysteinate dimer(Tc-99m-ECD) single photon emission computed tomography(SPECT) scans. Materials and Methods:Twenty-eight TBI patients without structural abnormality on MRI(mild, n=13/moderate, n=9/severe, n=6) and fifteen normal controls were scanned by SPECT. A voxel-based analysis using statistical parametric mapping(SPM) was performed to compare the patients with the normal controls. Results:rCBF was reduced in the right uncus and the right lateral orbitofrontal gyrus in the TBI patients. However, no increase of rCBF was noted in the patients in comparison to the normal controls. Conclusions:These results suggest that the TBI patients, even in the absence of structural lesion of the brain, may have dysfunction of the brain, particularly of the orbitofrontal and anterior pole of the temporal cortex. They also suggest that SPECT can be a useful method to identify brain dysfunctions in combination with structural brain imaging and neuropsychological tests.

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Determination of In-Vivo Glenohumeral Translation During Loaded and Unloaded Arm Elevation

  • Nishinaka, Naoya;Mihara, Kenichi;Suzuki, Kazuhide;Makiuchi, Daisuke;Matsuhisa, Takayuki;Tsutsui, Hiroaki;Kon, Yoshiaki;Banks, Scott A.
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2009.03a
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    • pp.44-44
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    • 2009
  • The purpose of this study was to investigate humeral translation relative to the glenoid invivo during loaded and unloaded shoulder abduction. CT scans of 9 healthy shoulders were acquired and 3D models were created. The subject was positioned in front of a fluoroscope and motions were recorded during active abduction. The subjects performed two trials of holding a 3kg weight and unload. 3D motions were determined using model-based 3D-to-2D registration to obtain 6 degrees of freedom kinematics. Glenohumeral translation was determined by finding the location on the humeral head with the smallest separation from the glenoid. Humeral translation was referenced to the glenoid center in the superior/inferior direction. The humerus moved an average of 2 mm, from inferior to central on the glenoid, during arm abduction for both conditions. The humeral head was centered within 1mm from the glenoid center above $70^{\circ}$. There were no statistically significant differences for both conditions. The standard deviation decreased gradually over the motion, with significantly lower variability at the end of abduction compared to the initial unloaded position. We assumed that the humeral translation to the center of the glenoid provides maximum joint congruency for optimal shoulder function and joint longevity. We believe this information will lead to better strategies to prevent shoulder injuries, enhance rehabilitation, and improve surgical treatments.

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Extrapleural Pneumonectomy for Diffuse Malignant Mesothelioma -A Case Report- (미만형 악성 중퍼세포종의 늑막폐절제술 -1례 보고-)

  • Kim, Byeong-Gu;Bae, Sang-Il;O, Tae-Yun;Jang, Un-Ha
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.664-668
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    • 1996
  • Malignant mesothelioma has been considered a uniformly fatal disease associated with a median survival of 4 to 18 months. However, a multimodality approach toward therapy may Increase the length of palliation when a maximal resection of tumor is achieved. Recently we have experienced a 49 years-old male patient who had d ffuse malignant mesothelioma. The patient has complained of blood-tinged sputum and right chest pain for several months. Chest x-rays and CT scans showed compact haziness in the right entire thorax with massive bloody elusion, diffuse pleural thickening and collapsed underlying lung. We performed extrapleural pneumonectomy, and postoperative chemotherapy with cisplatin and mltomycin (Memorial Sloan-fettering Cancer Center method) was done. We are observing him for months now and there is no evidence of local recurrence.

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The Role of the Narrow Band Imaging for Lung Cancer (폐암에서의 협대역 내시경의 역할)

  • Park, Jinkyeong;Choi, Chang Min
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.5-8
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    • 2011
  • The proliferation of new technologies has significantly enhanced the diagnostic capabilities of flexible bronchoscopy compared with traditional methods. Narrow band imaging (NBI), an optical technique in which filtered light enhances superficial neoplasms based on their neoangiogenic patterns, was developed to screen for central intraepithelial moderate or severe dysplasia, carcinoma in situ (CIS), and microinvasive neoplasia in patients at risk for lung cancer. Because angiogenesis occurs preferentially in dysplastic and neoplastic lesions, NBI may identify early dysplastic lesions better than white light bronchoscopy (WLB) currently in use. NBI bronchoscopy can be used not only to detect precancerous lesions, but also to screen for cancerous lesions. We prospectively evaluated 101 patients with suspected lung cancer between July 2009 and June 2010. All were previously scheduled for flexible bronchoscopy CT scans. Abnormal NBI was defined by Shibuya's descriptors (tortuous, dotted, or spiral and screw patterns). Biopsies of 132 lesions in 92 patients showed that 78 lesions (59.1%) were malignant and 54 (40.9%) were benign. The diagnostic sensitivity of bronchoscopy in detecting malignancy was 96.2% (75/78). When assorted by lesion pattern, the sensitivity and specificity of NBI bronchoscopy in detecting malignancies were 69.2% (54/78) and 96.3% (52/54), respectively, for the spiral and screw pattern and 14.1% (11/78) and 96.3% (52/54), respectively, for the dotted pattern. Unexpectedly, additional cancerous lesions were detected in five patients (2 dotted and 3 spiral and screw). As a screening tool for malignant lesions, NBI bronchoscopy should assess combinations of all three lesion. The dotted and spiral and screw patterns may be helpful in determining which lesions should be biopsied. NBI bronchoscopy may be useful not only for the diagnosis of early-stage lung cancer but also for more accurate local staging of lung cancer.

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Pedicular and Extrapedicular Morphometric Analysis in the Korean Population : Computed Tomographic Assessment Relevance to Pedicle and Extrapedicle Screw Fixation in the Thoracic Spine

  • Kim, Jun-Hak;Choi, Gyeong-Mi;Chang, In-Bok;Ahn, Sung-Ki;Song, Joon-Ho;Choi, Hyun-Chul
    • Journal of Korean Neurosurgical Society
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    • v.46 no.3
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    • pp.181-188
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    • 2009
  • Objective : To evaluate the anatomical parameters that must be considered when performing thoracic transpedicular or extrapedicular screw fixation. Methods : We selected 958 vertebrae (1,916 pedicles) from 98 patients for analysis. Eight parameters were measured from CT scans : the transverse outer pedicular diameter, transverse inner pedicular diameter, length, angle, chord length of the pedicles and the transverse width, angle, and chord length of the pedicle-rib units. Results : The age of the patients ranged from 21 to 82 years (mean: 48.2 years) and there were 57 men and 41 women. The narrowest transverse outer pedicular diameter was at T5 (4.4 mm). The narrowest pedicle length was at T1 (15.9 mm). For pedicle angle, T1 was 31.6 degrees, which was the most convergent angle, and it showed the tendency of the lower the level, the lesser the convergent angle. The chord length showed a horizontal pattern with similar values at all levels. For the PRU width, T5 showed a similar pattern to the pedicle width at 13.4 mm. For the PRU angle, T1 was the largest angle at 46.2 degrees and the tendency was the lower the level. the narrower the angle. For chord length, T1 was the shortest at 46.9 mm and T8 was the longest at 60.1 mm. Conclusion : When transpedicular screw fixations carried out at the mid-thoracic level, special care must be taken because there is a high chance of danger of medial wall violation. In these circumstances, extrapedicular screw fixation may be considered as an alternative treatment.

A radiologic study of ameloblastoma using computed tomography (전산화 단층촬영을 이용한 법랑모세포종의 방사선학적 연구)

  • Park Hyok;Jeong Ho-Gul;Kim Kee-Deog;Park Chang-Seo
    • Imaging Science in Dentistry
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    • v.35 no.2
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    • pp.77-82
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    • 2005
  • Purpose : To reveal what is the distinct differential diagnostic differences between unicystic ameloblastoma and solid or multicystic ameloblastoma. Materials and Methods : 56 cases of ameloblastoma were retrospectively reviewed and evaluated among the patients who had taken CT scans at the department of Oral & Maxillofacial Radiology in Yonsei University Dental Hospital from January 1996 to December 2003. Results : In 56 cases, 21 cases $(37.5\%)$ were unicystic ameloblastoma, 35 cases $(62.5\%)$ were solid or multicystic ameloblastoma. Only 1 case $(4.8\%)$ of unicystic ameloblastoma and 4 cases $(11.4\%)$ of solid or multicystic ameloblastoma were occurred in maxilla. 13 cases $(61.9\%)$ of unicystic ameloblastoma were observed as unilocular, and 8 cases $(38.1\%)$ as lobulated. 5 cases $(14.3\%)$ of solid or multicystic ameloblastoma were observed as unilocular, 13 cases $(37.1\%)$ as lobulated, and 17 cases $(48.6\%)$ as multilocular. Tn the results from the measurements after correction of the buccolingual widths and heights to the mesiodistal lengths, there is a statistically significant difference between unicystic ameloblastoma and solid or multicystic ameloblastoma in ANCOVA test (p<0.05). Hounsfield units in the lesion were $24.9{\pm}8.8\;HU$ in unicystic ameloblastoma, $31.2{\pm}11.5\;HU$ in solid or multicystic ameloblastoma. There is no statistically significant difference (p>0.05). Conclusion : Characteristic differences between unicystic ameloblastoma and solid or multicystic ameloblastoma is that there is higher prevalence of solid or multicystic ameloblastoma that have lobulated or multilocular patterns. To measure the Hounsfield units in the lesion is helpful, but it is not a differential diagnostic point between unicystic ameloblastoma and solid or multicystic ameloblastoma.

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Buccal cortical bone thickness on CBCT for mini-implant (치과용 콘빔CT영상에서 미니임플란트를 위한 협측피질골 두께)

  • Goo, Jong-Gook;Lim, Sung-Hoon;Lee, Byoung-Jin;Kim, Jae-Duk
    • Imaging Science in Dentistry
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    • v.40 no.4
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    • pp.179-185
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    • 2010
  • Purpose : Cortical bone thickness is one of the important factor in mini-implant stability. This study was performed to investigate the buccal cortical bone thickness at every interdental area as an aid in planning mini-implant placement. Materials and Methods : Two-dimensional slices at every interdental area were selected from the cone-beam computed tomography scans of 20 patients in third decade. Buccal cortical bone thickness was measured at 2, 4, and 6 mm levels from the alveolar crest in the interdental bones of posterior regions of both jaws using the plot profile function of $Ez3D2009^{TM}$ (Vatech, Yongin, Korea). The results were analyzed using by Mann-Whitney test. Results : Buccal cortical bone was thicker in the mandible than in the maxilla. The thickness increased with further distance from the alveolar crest in the maxilla and with coming from the posterior to anterior region in the mandible (p<0.01). The maximum CT value showed an increasing tendency with further distance from the alveolar crest and with coming from posterior to anterior region in both jaws. Conclusion : Interdental buccal cortical bone thickness varied in both jaws, however our study showed a distinct tendency. We expect that these results could be helpful for the selection and preparation of mini-implant sites.

Cone-beam CT analysis of patients with obstructive sleep apnea compared to normal controls

  • Buchanan, Allison;Cohen, Ruben;Looney, Stephen;Kalathingal, Sajitha;De Rossi, Scott
    • Imaging Science in Dentistry
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    • v.46 no.1
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    • pp.9-16
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    • 2016
  • Purpose: To evaluate the upper airway dimensions of obstructive sleep apnea (OSA) and control subjects using a cone-beam computed tomography (CBCT) unit commonly applied in clinical practice in order to assess airway dimensions in the same fashion as that routinely employed in a clinical setting. Materials and Methods: This was a retrospective analysis utilizing existing CBCT scans to evaluate the dimensions of the upper airway in OSA and control subjects. The CBCT data of sixteen OSA and sixteen control subjects were compared. The average area, average volume, total volume, and total length of the upper airway were computed. Width and anterior-posterior (AP) measurements were obtained on the smallest axial slice. Results: OSA subjects had a significantly smaller average airway area, average airway volume, total airway volume, and mean airway width. OSA subjects had a significantly larger airway length measurement. The mean A-P distance was not significantly different between groups. Conclusion: OSA subjects have a smaller upper airway compared to controls with the exception of airway length. The lack of a significant difference in the mean A-P distance may indicate that patient position during imaging (upright vs. supine) can affect this measurement. Comparison of this study with a future prospective study design will allow for validation of these results.

A Case of Pulmonary Sequestration Infected by $Mycobacterium$ $tuberculosis$ (폐결핵이 동반된 폐격리증 1예)

  • Shin, Ji-Young;Park, Hee-Sun;Yoo, Su-Jin;Jung, Sun-Young;Park, Ji-Won;Kim, Ju-Ock;Kim, Sun-Young;Lee, Jeong-Eun
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.1
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    • pp.79-83
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    • 2011
  • Pulmonary sequestration is a rare anomaly, in which a local area of a lung is supplied separately by an anomalous artery that arises from the aorta or one of its branches. Infection, mainly bacterial, is a major complication of sequestration. We report the case of a 17-year-old male patient, who presented with cough and fever. The contrast-enhanced chest computer tomomgraphy (CT) scans revealed an aberrant artery that originated from the descending thoracic aorta. He underwent a left-lower lobectomy. Macroscopically, the abnormal segment presented as multiple heterogenous cystic and solid lesions, and the cysts were filled with mucoid and pus-like material. Histology showed that the pulmonary parenchyma had been replaced by caseating epitheloid granulomas. The mycobacterial culture of his sputum was positive. On the basis of these results, the diagnosis of tuberculosis was established. The patient was treated with anti-tuberculous medication for 6 months, and 1 year later, his clinical status remained excellent.

Effects of the Combination Chemotherapy of Docetaxel and Cisplatin in Non-Small Cell Lung Cancer Patients (비소세포성 폐암환자에서의 Docetaxel과 Cisplatin의 복합요법에 대한 효과)

  • Bang, Eun Sook;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.12 no.1
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    • pp.1-6
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    • 2002
  • Central Cancer Registry of Korean National Cancer Center in 1999 reported that mortality from lung cancer is higher than mortality from stomach cancer or hepatocellular carcinoma in Korean male. Lung cancer is classified into small cell cancer and non-small cell lung cancer (NSCLC), and NSCLC patients account for $70\%$ of the whole lung cancer patients. The purpose of this study was to evaluate the efficacy and toxicity of docetaxel and cisplatin combination in Korean patients with NSCLC. All patients who had received the combination therapy of docetaxel and cisplatin for histologically confirmed NSCLC in Ajou University Hospital between 2000. $2\~2001$. 4 were retrospectively evaluated for the responses and toxicities of that combination therapy. Nineteen patients were treated with docetaxel 75 $mg/m^2$ on Day 1 and cisplatin 25 $mg/m^2$ on Day 1-3 every 4 weeks. The response for combination regimen was evaluated by CT scans after 2 or 3 cycles of treatments. Seventeen patients were evaluated for the responses and the 19 patients far the toxicities. Among the 19 patients (14 men and 5 women), there were one patient $(5.3\%)$ with stage I disease, 4 patients $(21.1\%)$ with stage III disease, and 14 patients $(73.1\%)$ with stage IV disease. Of the 17 patients who were evaluable for response, complete response (CR) was not observed in any patient while partial response (PR) was observed in 5 patients $(29.4\%)$. The overall response rate (CR+PR) was $29.4\%$. Stable disease (SD) was observed in 11 patients $(64.7\%)$ and progressive disease (PD) in 1 patient $(5.9\%)$. The toxicities were graded by NCI (National Cancer Institute) Common Toxicity Criteria for the evaluable 70 cycles. Grade 3 or 4 neutropenia occurred in 53 cycles $(76\%)$. Four patients were hospitalized due to febrile neutropenia. The combination chemotherapy of docetaxel and cisplatin was effective as NSCLC treatments, however, the regimen must be administered carefully due to its hematological side effects.

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