• Journal of Chest Surgery
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• 제31권12호
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• pp.1243-1246
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• 1998

외상에 의한 기관-기관지 손상은 비교적 드물고 경부 부위를 제외하곤 국내에서는 대부분 둔상에 기인한다. 기관-기관지는 흉부 내에 깊이 있어 비교적 자상에 의한 손상은 적다. 저자들은 제5흉추 우측 옆부위의 자상으로 인한 기정맥과 좌측 주 기관지의 파열 1례를 치험하였다. 환자는 24세 남자로 응급실에서 촬영한 단순 흉부엑스선 사진상 흉부내에 칼이 보였다. 칼은 응급실에서 제거하지 않았다. 환자는 기관지 내시경 검사나 전산화 단층촬영 없이 내원 30분내 수술실로 옮겨 개흉하여 과도을 제거하였다. 사선으로 파열된 기정맥과 좌측 주 기관지를 봉합하였다. 환자는 술 후 14일째 특별한 문제없이 퇴원하였다.

• 대한두개안면성형외과학회지
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• 제13권2호
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• pp.151-155
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• 2012

Purpose: Basal cell adenoma of the salivary gland is an uncommon type of monomorphic adenoma. The most frequent location is parotid gland. It usually appears as a firm, mobile and slow-growing mass. Originally the term "basal cell adenoma" is described as a benign salivary gland tumor comprised of uniform appearing basaloid cells which are arranged in solid, trabecular, tubular, and membranous patterns. But the myxoid and chondroid mesenchymal like component as seen in pleomorphic adenoma is lacking in basal cell adenoma. We report a case of basal cell adenoma of parotid gland with review of the literatures. Methods: The 59-year-old female patient was referred to our department with a painless palpable mass in the left preauricular region for about 1 year. Movable and nontender subcutaneous mass was palpable. There was no evidence of cervical metastasis in computed tomography and ultrasonography. On fine needle aspiration cytology, pleomorphic adenoma was suspected. Under general anesthesia, superficial parotidectomy including tumor was performed. The biopsy result was basal cell adenoma. Results: Long-term follow-up for 54 months showed favorable result without evidence of recurrence except for temporary facial nerve weakness right after the surgery. Conclusion: Basal cell adenoma is the third most frequent benign tumor of the salivary gland, following pleomorphic adenoma and Warthin's tumor, although the incidence is low. The typical clinical feature of the basal cell adenoma is slowly growing, asymptomatic, and freely movable parotid mass. Basal cell adenoma should be also considered as a differential diagnosis of the parotid gland benign tumor.

• 대한치과의사협회지
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• 제44권2호통권441호
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• pp.115-122
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• 2006

Objective : The purpose of this study was to evaluate the dimensional errors between real tooth, 3D CT image and CARP model. Materials and Methods : Two maxilla and two mandible block bones with intact teeth were taken from two cadavers. Computed tomography was taken either in dry state and in wet state. After then, all teeth were extracted and the dimensions of the real teeth were measured using a digital caliper at mesio-distal and bucco-lingual width both in crown and cervical portion. 3D CT image was generated using the V-works $4.0^{TM}$ (Cybemed Inc., Seoul, Korea) software. Twelve teeth were randomly selected for CARP model fabrication. All the measurements of 3D Ct images and CARP models were made in the same manner of the real tooth group. Dimensional errors between real tooth, 3D CT image model and CARP model was calculated. Results : 1) Average of absolute error was 0.199 mm between real teeth and 3D CT image model, 0.169 mm between 3D CT image model and CARP model and 0.291 mm between real teeth and CARP model, respectively. 2) Average size of 3D CT image was smaller than real teeth by 0.149 mm and that of CARP model was smalier than 3D CT image model by 0.067mm. Conclusion : Within the scope of this study, CARP model with the 0.291 mm average of absolute eror can aid to enhance the success rate cf autogenous tooth transplantation due to the increased accuracy of recipient bone and donor tooth.

• 대한두경부종양학회지
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• 제33권1호
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• pp.73-77
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• 2017

경동맥에서 발생하는 가성동맥류는 비교적 드문 질환으로 주로 외상, 감염, 수술의 합병증 또는 방사선 치료 후에 합병증으로 발생할 수 있다. 비정형 결핵성 림프절염에 의한 경동맥 가성동맥류는 거의 보고된 바 없으며 따라서 비정형 결핵성 림프절염이 동반된 환자에서는 급성악화에 의한 농양형성으로 오인될 수 있다. 비정형 결핵성 림프절염으로 치료중인 81세 남자 환자에서 이러한 경험을 하였기에 문헌고찰과 함께 보고하고자 한다.

• Radiation Oncology Journal
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• 제30권1호
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• pp.36-42
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• 2012

Purpose: To evaluate the radial displacement of clinical target volume in the patients with node negative head and neck (H&N) cancer and to quantify the relative positional changes compared to that of normal healthy volunteers. Materials and Methods: Three node-negative H&N cancer patients and five healthy volunteers were enrolled in this study. For setup accuracy, neck thermoplastic masks and laser alignment were used in each of the acquired computed tomography (CT) images. Both groups had total three sequential CT images in every two weeks. The lymph node (LN) level of the neck was delineated based on the Radiation Therapy Oncology Group (RTOG) consensus guideline by one physician. We use the second cervical vertebra body as a reference point to match each CT image set. Each of the sequential CT images and delineated neck LN levels were fused with the primary image, then maximal radial displacement was measured at 1.5 cm intervals from skull base (SB) to caudal margin of LN level V, and the volume differences at each node level were quantified. Results: The mean radial displacements were 2.26 (${\pm}1.03$) mm in the control group and 3.05 (${\pm}1.97$) in the H&N cancer patients. There was a statistically significant difference between the groups in terms of the mean radial displacement (p = 0.03). In addition, the mean radial displacement increased with the distance from SB. As for the mean volume differences, there was no statistical significance between the two groups. Conclusion: This study suggests that a more generous radial margin should be applied to the lower part of the neck LN for better clinical target coverage and dose delivery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권6호
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• pp.278-284
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• 2014

Objectives: This study used cone-beam computed tomography (CBCT) images to categorize the relationships between the mandibular canal and the roots and investigated the prevalence of nerve damage. Materials and Methods: Through CBCT images, contact and three-dimensional positional relationships between the roots of the mandibular third molar and the mandibular canal were investigated. With this data, prevalence of nerve damage according to the presence of contact and three-dimensional positional relationships was studied. Other factors that affected the prevalence of nerve damage were also investigated. Results: When the mandibular third molar and the mandibular canal were shown to have direct contact in CBCT images, the prevalence of nerve damage was higher than in other cases. Also, in cases where the mandibular canal was horizontally lingual to the mandibular third molar and the mandibular canal was vertically at the cervical level of the mandibular third molar, the prevalence of nerve damage was higher than in opposite cases. The percentage of mandibular canal contact with the roots of the mandibular third molar was higher when the mandibular canal was horizontally lingual to the mandibular third molar. Finally, the prevalence of nerve damage was higher when the diameter of the mandibular canal lumen suddenly decreased at the contact area between the mandibular canal and the roots, as shown in CBCT images. Conclusion: The three-dimensional relationship of the mandibular third molar and the mandibular canal can help predict nerve damage and can guide patient expectations of the possibility and extent of nerve damage.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.322-327
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• 2001

Objectives : There are many kinds of method to evaluate neural decompression during operation. They are direct visual and manual inspection, intraoperative ultrasound, endoscope, intraoperative computed tomography and intraoperative myelography. We used intraoperative myelography to evaluate the proper decompression of neural elements during the decompressive surgery. Methods : We injected 10-20cc of nonionic water-soluble contrast materials through direct puncture site of exposed dura during operation or lower lumbar level or lumbar drain inserted preoperatively. 12 patients were included in this study. They were 7 patients of centrally herniated lumbar disc disease, 1 patient of multiple lumbar spinal stenosis, 2 patients of thoracic extradural tumor and 2 cervical fracture & dislocations. Results : 5 of 12 patients showed remained neural compression through intraoperative myelography, so they were operated further through other approach. Myelographic dye is heavier than CSF, so the dependent side of subarachnoid space was visualized only. In one case, CSF leakage through hemovac was detected, but it was treated only bed rest for 5 days after hemovac removal. Conclusion :Intraoperative myelography is an effective method to evaluate neural decompression during spinal surgery. This technique is easy and familiar to us, neurosurgeons.

• Journal of Korean Neurosurgical Society
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• 제60권4호
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• pp.441-447
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• 2017

Objective : Computed tomography (CT)-based method of three dimensional (3D) analysis ($MIMICS^{(R)}$, Materialise, Leuven, Belgium) is reported as very useful software for evaluation of OPLL, but its reliability and reproducibility are obscure. This study was conducted to evaluate the accuracy of $MIMICS^{(R)}$ system, and inter- and intra-observer reliability in the measurement of OPLL. Methods : Three neurosurgeons independently analyzed the randomly selected 10 OPLL cases with medical image processing software ($MIMICS^{(R)}$) which create 3D model with Digital Imaging and Communication in Medicine (DICOM) data from CT images after brief explanation was given to examiners before the image construction steps. To assess the reliability of inter- and intra-examiner intraclass correlation coefficient (ICC), 3 examiners measured 4 parameters (volume, length, width, and length) in 10 cases 2 times with 1-week interval. Results : The inter-examiner ICCs among 3 examiners were 0.996 (95% confidence interval [CI], 0.987-0.999) for volume measurement, 0.973 (95% CI, 0.907-0.978) for thickness, 0.969 (95% CI, 0.895-0.993) for width, and 0.995 (95% CI, 0.983-0.999) for length. The intra-examiner ICCs were 0.994 (range, 0.991-0.996) for volume, 0.996 (range, 0.944-0.998) for length, 0.930 (range, 0.873-0.947) for width, and 0.987 (range, 0.985-0.995) for length. Conclusion : The medical image processing software ($MIMICS^{(R)}$) provided detailed quantification OPLL volume with minimal error of inter- and intra-observer reliability in the measurement of OPLL.

• 한국임상수의학회지
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• 제39권5호
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• pp.235-239
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• 2022

A 10-year-old neutered male Siberian Husky presented with paraparesis and severe lethargy. On physical examination, the patient was unable to weight-bear and walk and exhibited significant muscle mass loss in both hindlimbs and generalized truncal alopecia with a dull coat of hair. On neurological examination, cranial lumbar vertebral pain, hind limb cross-extensor reflex, delayed hindlimb postural reaction, upper motor neuron bladder dysfunction, and total absence of cutaneous trunci reflex were identified. Computed tomography revealed diffuse idiopathic skeletal hyperostosis and spondylosis deformans of the cervical and thoracolumbar vertebrae. In addition, a generalized decrease in bone mineral density of the vertebrae was identified. Magnetic resonance imaging showed hyperplasia of the epidural fat compressing the spinal cord in the thoracolumbar region and concurrent mild multiple intervertebral disc herniations. No specific findings were observed in cerebrospinal fluid analysis. Blood analysis of thyroid function revealed decreased total T4 and free T4 levels, and increased TSH levels. The patient was tentatively diagnosed with spinal epidural lipomatosis (SEL) secondary to hypothyroidism. The patient was treated with levothyroxine, firocoxib, and gabapentin. Clinical signs gradually improved, and the patient showed normal ambulation 40 days after treatment initiation. SEL is extremely rare in dogs. To the best of our knowledge, this is the first case report of SEL secondary to hypothyroidism that was treated conservatively. Secondary SEL can be sufficiently managed by treating the underlying cause, if possible.

• Restorative Dentistry and Endodontics
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• 제46권4호
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• pp.56.1-56.11
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• 2021

Objectives: This study evaluated 2 nickel-titanium rotary systems and a complementary protocol with an ultrasonic tip and a small-diameter instrument in flattened root canals. Materials and Methods: Thirty-two human maxillary second premolars with flattened canals (buccolingual diameter ≥4 times larger than the mesiodistal diameter) at 9 mm from the radiographic apex were selected. The root canals were prepared by ProDesign Logic (PDL) 30/0.01 and 30/0.05 or Hyflex EDM (HEDM) 10/0.05 and 25/0.08 (n = 16), followed by application of the Flatsonic ultrasonic tip in the cervical and middle thirds and a PDL 25/0.03 file in the apical third (FPDL). The teeth were scanned using micro-computed tomography before and after the procedures. The percentage of volume increase, debris, and uninstrumented surface area were analyzed using the Kruskal-Wallis, Dunn, Wilcoxon, analysis of variance/Tukey, and paired and unpaired t-tests (α = 0.05). Results: No significant difference was found in the volume increase and uninstrumented surface area between PDL and HEDM (p > 0.05). PDL had a higher percentage of debris than HEDM in the middle and apical thirds (p < 0.05). The FPDL protocol resulted in less debris and uninstrumented surface area for PDL and HEDM (p < 0.05). This protocol, with HEDM, reduced debris in the middle and apical thirds and uninstrumented surface area in the apical third (p < 0.05). Conclusions: High percentages of debris and uninstrumented surface area were observed after preparation of flattened root canals. The HEDM, Flatsonic tip, and 25/0.03 instrument protocol enhanced cleaning in flattened root canals.