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Penetrating Injuries by Foreign Body in the Head and Neck Region (두경부의 이물질 삽입에 의한 관통성 외상)

  • Hong, Soon-Xae;Baek, Ji-Young;Cha, In-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.3
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    • pp.351-355
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    • 2000
  • Penetrating injuries in the head and neck region are not common but can pose difficult situations to manage properly. In small cross-sectional area, the neck housed many vital structures, such as carotid artery, internal jugular vein, cervical spines, esophagus, laryngotracheal complex and nerves. Because each vital structure is located within the fascial compartments, bleeding into these closed spaces can give rise to compression of surrounding structures, which may result in compromised airway. Therefore, management of the penetrating injuries should be based on the fully understanding of anatomical relationships, accurate clinical examinations, a careful history taking and the proper treatment planning. We present two cases of penetrating injuries in the head and neck region and discuss on the clinical considerations for the proper management with the literature review.

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Three-dimensional intraoperative computed tomography imaging for zygomatic fracture repair

  • Peleg, Oren;Ianculovici, Clariel;Shuster, Amir;Mijiritsky, Eitan;Oz, Itay;Kleinman, Shlomi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.5
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    • pp.382-387
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    • 2021
  • Objectives: Zygomatic complex (ZMC) fractures comprise up to 40% of all facial fractures. Misaligned bone fragments and misplaced fixation hardware traditionally detected postoperatively on plain radiographs of the skull might require re-operation. The intraoperative O-Arm (Medtronic, USA) is a three-dimensional (3D) computed tomographic imaging system. Materials and Methods: This retrospective single-center study evaluated the utility of O-Arm scanning during corrective surgeries for ZMC and zygomatic arch (ZA) fractures from 2018 to 2020. Three females and 16 males (mean age, 31.52 years; range, 22-48 years) were included. Fracture instability (n=6) and facial deformity (n=15) were the most frequent indications for intraoperative 3D O-Arm scan. Results: The images demonstrated that all fracture lines were properly reduced and fixed. Another scan performed at the end of the fixation or reduction stage, however, revealed suboptimal results in five of the 19 cases, and further reduction and fixation of the fracture lines were required. Conclusion: Implementation of an intraoperative O-Arm system in ZMC and ZA fracture surgeries assists in obtaining predictable and accurate results and obviates the need for revision surgeries. The device should be considered for precise operations such as ZMC fracture repairs.

Shoulder Arthrokinematics of Collegiate Ice Hockey Athletes Based on the 3D-2D Model Registration Technique

  • Jeong, Hee Seong;Song, Junbom;Lee, Inje;Kim, Doosup;Lee, Sae Yong
    • Korean Journal of Applied Biomechanics
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    • v.31 no.3
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    • pp.155-161
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    • 2021
  • Objective: There is a lack of studies using the 3D-2D image registration techniques on the mechanism of a shoulder injury for ice hockey players. This study aimed to analyze in vivo 3D glenohumeral joint arthrokinematics in collegiate ice hockey athletes and compare shoulder scaption with or without a hockey stick using the 3D-2D image registration technique. Method: We recruited 12 male elite ice hockey players (age, 19.88 ± 0.65 years). For arthrokinematic analysis of the common shoulder abduction movements of the injury pathogenesis of ice hockey players, participants abducted their dominant arm along the scapular plane and then grabbed a stick using the same motion under C-arm fluoroscopy with 16 frames per second. Computed tomography (CT) scans of the shoulder complex were obtained with a 0.6-mm slice pitch. Data from the humerus translation distances, scapula upward rotation, anterior-posterior tilt, internal to external rotation angles, and scapulohumeral rhythm (SHR) ratio on glenohumeral (GH) joint kinematics were outputted using a MATLAB customized code. Results: The humeral translation in the stick hand compared to the bare hand moved more anterior and more superior until the abduction angle reached 40°. When the GH joint in the stick hand was at the maximal abduction of the scapula, the scapula was externally rotated 2~5° relative to 0°. The SHR ratio relative to the abduction along the scapular plane at 40° indicated a statistically significant difference between the two groups (p < 0.05). Conclusion: With arm loading with the stick, the humeral and scapular kinematics showed a significant correlation in the initial section of the SHR. Although these correlations might be difficult in clinical settings, ice hockey athletes can lead to the movement difference of the scapulohumeral joints with inherent instability.

Evaluation of the Dose According to the Movement of Breath During Field-in-Field Technique Treatment of Breast Cancer Patients (유방암 환자의 Field-in-Field Technique 치료 시 호흡의 움직임에 따른 선량 평가)

  • Kwon, Kyung-Tae
    • Journal of radiological science and technology
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    • v.41 no.6
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    • pp.561-566
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    • 2018
  • Field-in-Field Technique is applied to the radiation therapy of breast cancer patients, and it is possible to compensate the difference in breast thickness and deliver uniform dose in the breast. However, there are several fields in the treatment field that result in a more complex dose delivery than a single field dose delivery. If the patient's respiration is irregular during the delivery of the dose by several fields and the change of respiration occurs, the dose distribution in the breast changes. Therefore, based on the computed tomography images of breast cancer patients, a human model was created by using a 3D printer (Builder Extreme 1000) to describe the volume in the same manner. A computerized tomography (CT) of the human body model was performed and a treatment plan of 260 cGy / fx was established using a 6-MV field-in-field technique using a computerized treatment planning system (Eclipse 13.6, Varian, USA). The distribution of the dose in the breast according to the change of the respiration was measured using a moving phantom at 0.1 cm, 0.3 cm, 0.5 cm amplitude, using a MOSOXIDE Silicon Field Effect Transistor (MOSFET, Best Medical, Canada) Were measured and compared. The distribution of dose in the breast according to the change of respiration showed similar value within ${\pm}2%$ in the movement up to 0.3 cm compared to the treatment plan. In this experiment, we found that the dose distribution in the breast due to the change of respiration when the change of respiration was increased was not much different from the treatment plan.

Fused roots of maxillary molars: characterization and prevalence in a Latin American sub-population: a cone beam computed tomography study

  • Marcano-Caldera, Maytte;Mejia-Cardona, Jose Luis;Blanco-Uribe, Maria del Pilar;Chaverra-Mesa, Elena Carolina;Rodriguez-Lezama, Didier;Parra-Sanchez, Jose Hernan
    • Restorative Dentistry and Endodontics
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    • v.44 no.2
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    • pp.16.1-16.12
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    • 2019
  • Objectives: The upper molars generally have three roots; therefore, different combinations of fusion can occur, increasing the possibility of finding more complex root canal systems. The purpose of this study was to evaluate the prevalence and characterization of fused roots in first and second maxillary molars using cone-beam computed tomography (CBCT) in a Colombian population. Materials and Methods: A total of 1274 teeth were evaluated, of which 534 were maxillary first molars and 740 were maxillary second molars. Axial sections were made at the cervical, middle, and apical levels to determine the prevalence of root fusion and the types of fusion. Results: Overall, 43% of the molars (n = 551) presented some type of fused root. Root fusion was present in 23.4% of the maxillary first molars. The most frequent type of fused root was type 3 (distobuccal-palatal; DB-P) (58.9%). Root fusion was observed in 57.6% of the maxillary second molars, and the most prevalent type of fused root was type 6 (cone-shaped) (45.2%). Of the maxillary molars, 12.5% were classified as C-shaped. Conclusion: Within the limitations of this study, there was a high prevalence of fused roots in maxillary molars in the Colombian population, mainly in the maxillary second molars. In first molars, the most common type of fused root was type 3 (DB-P) and in second molars, the most common type was type 6 (cone-shaped). Additionally, molars with root fusion presented variation at different levels of the radicular portion, with implications for treatment quality.

Tuberculous Empyema Necessitatis with Osteomyelitis, a Rare Case in the 21st Century (늑골 골수염에 동반된 흉벽 천공성 농흉 1례)

  • Kim, Han Wool;Lim, Goh-Woon;Cho, Hye Kyung;Lee, Hyunju;Won, Tae Hee;Park, Kyoung Un;Kim, Kyung-Hyo
    • Pediatric Infection and Vaccine
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    • v.18 no.1
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    • pp.80-84
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    • 2011
  • Empyema necessitatis refers to empyema that extends into the extrapleural space through a defect in the pleural surface. Tuberculous empyema necessitatis is a rare complication of tuberculosis. We experienced a 21-month-old boy with tuberculous empyema necessitatis with osteomyelitis in the right $7^{th}$ rib. He presented with a mass on the right lateral chest wall, which was soft and nontender, enlarging for one month. He also had mild fever. The plain radiograph of his chest revealed soft tissue swelling and calcified lymph node on the left axilla, and his PPD skin test was positive. CT scan of the chest showed empyema necessitatis at the right lower chest and upper abdominal walls with osteomyelitis of the right $7^{th}$ rib. He did not have concurrent pulmonary tuberculosis. Surgery was performed for diagnosis and treatment. In histopathologic findings, chronic granulomatous inflammation with caseation necrosis was shown and was positive for acid fast bacilli stain. In addition, M. tuberculosis complex was found as etiology by polymerase chain reaction. The patient has been treated with anti-tuberculous medication without any specific complication.

Rapid Detection Method for Human Rotavirus from Vegetables by a Combination of Filtration and Integrated Cell Culture/Real-Time Reverse Transcription PCR (Filtration과 Integrated Cell Culture/Real-Time Reverse Transcription PCR 기법을 이용한 채소류에서 Human Rotavirus 신속 검출)

  • Hyeon, Ji-Yeon;Chon, Jung-Whan;Song, Kwang-Young;Hwang, In-Gyun;Kwak, Hyo-Sun;Lee, Jung-Soo;Kim, Moo-Sang;Lee, Jung-Bok;Seo, Kun-Ho
    • Korean Journal of Microbiology
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    • v.47 no.2
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    • pp.117-123
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    • 2011
  • The purpose of this study was to evaluate and compare different elution and concentration methods for optimization of human rotavirus (HRV) detection method using real-time RT-PCR and cell culture techniques. The leafy vegetable samples (lettuce, Chinese cabbage) were artificially inoculated with HRV. Viruses were extracted from the vegetables by two different elution buffers, buffer A (100 mM Tris-HCl, 50 mM glycine, 3% beef extract, pH 9.5) and buffer B (250 mM Threonine, 300 mM NaCl, pH 9.5), and the extracted viruses were concentrated by filtration and PEG precipitation sequentially. To determine infectivity of the viruses, the viruses recovered from the samples were infected to the MA-104 cells, and integrated cell culture real-time RT-PCR was performed at 1, 48, 72, 96, 120, 144, 168 h post-infection (p.i.). The elution buffer A was more efficient in extracting the virus from the produce samples tested than the buffer B, 29.54% and 18.32% of recoveries, respectively. The sensitivity of real-time RT-PCR method was markedly improved when the virus was concentrated by the filtration method. When the viruses were eluted and concentrated by buffer A and filtration, respectively, the average recovery rate was approximately 51.89%. When the viruses recovered from samples were infected to MA-104 cell, infectious HRV was detected within 48 h p.i. by ICC/real-time RT-PCR, whereas cytopathic effects were not observed until 72 h p.i. The optimized detection method evaluated in this study could be useful for rapid and reliable detection of HRV in fresh produce products and applied for detection of other food-borne viruses.

The Pattern of Initial Displacement in Lingual Lever Arm Traction of 6 Maxillary Anterior Teeth According to Different Material Properties: 3-D FEA (유한요소모델에서 레버암을 이용한 상악 6전치 설측 견인 시 초기 이동 양상)

  • Choi, In-Ho;Cha, Kyung-Suk;Chung, Dong-Hwa
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.2
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    • pp.213-230
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    • 2008
  • The aim of this study was to analyze the initial movement and the stress distribution of each tooth and periodontal ligament during the lingual lever-arm retraction of 6 maxillary incisors using FEA. Two kinds of finite element models were produced: 2-properties model (simple model) and 24-properties model (multi model) according to the material property assignment. The subject was an adult male of 23 years old. The DICOM images through the CT of the patient were converted into the 3D image model of a skull using the Mimics (version 10.11, Materialise's interactive Medical Image Control System, Materialise, Belgium). After series of calculating, remeshing, exporting, importing process and volume mesh process was performed, FEA models were produced. FEA models are consisted of maxilla, maxillary central incisor, lateral incisor, canine, periodontal ligaments and lingual traction arm. The boundary conditions fixed the movements of posterior, sagittal and upper part of the model to the directions of X, Y, Z axis respectively. The model was set to be symmetrical to X axis. Through the center of resistance of maxilla complex, a retraction force of 200g was applied horizontally to the occlusal plane. Under this conditions, the initial movements and stress distributions were evaluated by 3D FEA. In the result, the amount of posterior movement was larger in the multi model than in the simple model as well as the amount of vertically rotation. The pattern of the posterior movement in the central incisors and lateral incisors was controlled tipping movement, and the amount was larger than in the canine. But the amount of root movement of the canine was larger than others. The incisor rotated downwardly and the canines upwardly around contact points of lateral incisor and canine in the both models. The values of stress are similar in the both simple and multi model.

Two Cases of Hot Tub Lung in Bodyscrubbers Working in a Public Bath (대중목욕탕 근무 후 발생한 온수 욕조 폐 2예)

  • Bak, Ji Young;Kim, Kwang Sil;Park, I-Nae;Yum, Ho-Kee;Lee, Seung Heon;Lee, Hyun-Kyung;Lee, Young Min;Jung, Hoon;Hur, Jin-Won;Lee, Seong Soon;Lee, Hyuk Pyo;Choi, Soo Jeon;Shin, Eun Ah;Choi, Sang Bong
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.1
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    • pp.37-41
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    • 2009
  • Hot tub lung has been described as a pulmonary illness associated with exposure to nontuberculous mycobacteria,mainly hot bathtub water contaminated with Mycobacterium avium complex (MAC) and hence the name. Although not entirely clear, its etiology has been thought to involve either an infection or a hypersensitivity pneumonitis secondary to MAC. Herein, we describe 2 female patients (60 and 53 years old) admitted to our hospital with hot tub lung, and both of whom worked in a public bath. Both women were initially admitted following several months of exertional dyspnea and cough. The patients had been working as body-scrubbers in a public bath for several years. Their chest CT scans showed bilateral diffuse ground-glass opacities with multifocal air-trappings and poorly defined centrilobular nodules in both lungs. Pathological findings from lung specimens revealed small non-necrotizing granuloma in the lung parenchyme with relatively normal-looking adjacent alveoli. Discontinuation of working in the public bath led to an improvement in symptoms and radiographic abnormalities, without antimycobacterial therapy.

Relationship between Admission and Clinical Features of Children Who Visited the Emergency Department with Seizures (경련을 주소로 응급실을 방문한 아이의 임상양상과 입원과의 관계)

  • Yoon, Sung Kwan;Kim, Eun Young;Yang, Eun Seok;Moon, Kyung Rye;Park, Sang Kee;Park, Young Bong;Rho, Young Il;Cho, Soo Hyeong
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.1003-1007
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    • 2003
  • Purpose : To review the seizure-related complaints and analyze the relationship between admission rates and clinical features in children who had visited the emergency department with seizures. Methods : Retrospectively, we reviewed 180 patients(male 100, female 80) suffering from seizures, who had visited to the emergency department of Chosun University Hospital from January 2000 to June 2002. We have analyzed the correlation between admission rate and clinical features such as age, seizure type, seizure duration and individual laboratory findings(CT or MRI, and CSF). Results : Out of 4,865 total children who visited the emergency department, 180 patients(3.7%) were seizure related. The most common seizure type was simple febrile seizure(52.2%). The admission rate of children with seizures was 48.9%. The admission rate according to age, sex and abnormal laboratory findings revealed no significant correlations(P>0.05). There was a significant correlation between admission and both status epilepticus 82.4%(14/17) and complex febrile seizure 63.6%(14/22) (P<0.05). According to the duration of convulsions, admission rates were 41.2% when within five minutes, 60% when six-15 minutes, 58.8% when 16-30 minutes, 85.7% when 30 minutes, to one hour and 66.7% when above one hour of duration. According to the seizure frequency, admission rates of recurrent seizure patients(61.4%=43/70) was higher compared to the first time seizure patients(40.9%=45/110). Conclusion : We found that the admission rate of children visiting the emergency department for seizure treatment was 48.9% and significantly correlated with duration, type and frequency of seizure.