• Annals of Clinical Neurophysiology
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• 제18권1호
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• pp.1-6
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• 2016

Background: Moyamoya disease is characterized by a progressive stenosis or occlusion of the intracranial internal carotid artery and/or the proximal portion of the anterior cerebral artery and middle cerebral artery. Whether the onset time was childhood or adulthood, the bony carotid canal diameter might be different, but reflects the size of internal carotid artery passing through the bony carotid canal. In this study, we aimed to identify the relationship between bony carotid canal diameter and clinical manifestation. Methods: 146 consecutive patients diagnosed with moyamoya disease by brain imaging studies were included. We measured the diameter of a transverse portion of bony carotid canal on bone window of a brain computed tomography(CT) image. Patients were divided into two groups, ischemic or hemorrhagic stroke according to clinical manifestation. As a result, 115 patients were included. The Suzuki stage was used as criteria for disease progression. Results: Bony carotid canal diameter was $3.6{\pm}0.5$ (right) and $3.6{\pm}0.4$ (left) in the hemorrhagic stroke group, and $3.7{\pm}0.4$ (right) and $3.6{\pm}0.4$ (left) in the ischemic stroke group. The bony carotid canal diameter of the moyamoya vessels (3.6 mm) was smaller than the diameter of non-moyamoya vessels (3.8 mm), significantly (p = 0.042). However, there was no difference in the collateral patterns and clinical manifestation in a comparison of both groups. Conclusions: In our study, there was no significant difference of clinical manifestations and collateral patterns depend on the bony carotid canal diameter in patients with moyamoya disease. These findings suggest that the clinical presentations of moyamoya disease are not related to the onset time of the disease.

• 대한족부족관절학회지
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• 제21권2호
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• pp.61-65
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• 2017

Purpose: The purpose of this study was to determine the correlation and ratio between the calcaneal length and width for predicting the width of calcaneus. Materials and Methods: A total of 190 feet (190 patients) were included based on computed tomography scans. The length of calcaneus (CL) was measured on the line connecting the center of a circle tangent to the cortical margin in the anterior and posterior parts of the calcaneus in a sagittal plane (W1, W2). The width of the calcaneus was defined as the horizontal line of each part (W1, W2, W3) on the same axial plane. The relationship between the measurement was determined through a correlation analysis. The reliability was assessed based on intraclass correlation coefficients. Results: The CL and widths of calcaneus (W1, W2, W3) had a good positive correlation (r=0.848 [W1/CL], r=0.738 [W2/CL], r=0.769 [W3/CL]; p<0.001). The mean CL and widths ratios were 0.33 (W1/CL), 0.37 (W2/CL), and 0.37 (W3/CL). Using these ratios to estimate the widths by multiplying each ratio by the measured calcaneal length, we found a difference between the estimated calcaneal widths and the actual measured calcaneal widths values was 0.25 mm, 0.43 mm, and 0.16 mm. All measurements showed good-to-excellent inter- and intraobserver reliability. Conclusion: This study analyzed the correlation and ratio between the length and width of the calcaneus. The results will help orthopedic surgeons fixate screws in a stable manner to prevent iatrogenic injuries to the medial neurovascular structures of the calcaneus.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권6호
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• pp.473-479
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• 2012

Warthintumor (WT), also known as adenolymphoma or papillary cystadenoma lymphomatosum, was described in 1895 for the first time. It is a common benign tumor of the parotid glands and the second most common neoplasm of the salivary gland, accounting for 5% to 14% of all parotid neoplasm. A 63-year-old man visited our clinic with the complaint of swelling on the right parotid gland. Physical examination showed a 3 cm, firm, well-circumscribed, painless mass on the right mandibular angle. Computed tomography imaging showed a $3.5{\times}2.0{\times}1.6$ cm well-defined cystic mass. WT is histologically characterized by bilayered, oncocystic cell, lymphoid stroma, and cystic space. With these typical cytomorphologic characteristics, the fine-needle aspiration cytology was performed as diagnostic tool before the surgery. The lymphocytes and oncocystic cell were not observed. The lesion was completely excised under general anesthesia. We diagnosed the case as WT, from the surgically excised specimen. We report on the case with a review of the literatures.

• Imaging Science in Dentistry
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• 제46권2호
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• pp.103-108
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• 2016

Purpose: The current study investigates the feasibility of a platform for a nationwide dose monitoring system for dental radiography. The essential elements for an unerring system are also assessed. Materials and Methods: An intraoral radiographic machine with 14 X-ray generators and five sensors, 45 panoramic radiographic machines, and 23 cone-beam computed tomography (CBCT) models used in Korean dental clinics were surveyed to investigate the type of dose report. A main server for storing the dose data from each radiographic machine was prepared. The dose report transfer pathways from the radiographic machine to the main sever were constructed. An effective dose calculation method was created based on the machine specifications and the exposure parameters of three intraoral radiographic machines, five panoramic radiographic machines, and four CBCTs. A viewing system was developed for both dentists and patients to view the calculated effective dose. Each procedure and the main server were integrated into one system. Results: The dose data from each type of radiographic machine was successfully transferred to the main server and converted into an effective dose. The effective dose stored in the main server is automatically connected to a viewing program for dentist and patient access. Conclusion: A patient radiation dose monitoring system is feasible for dental clinics. Future research in cooperation with clinicians, industry, and radiologists is needed to ensure format convertibility for an efficient dose monitoring system to monitor unexpected radiation dose.

• 디지털융복합연구
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• 제12권10호
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• pp.385-390
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• 2014

이 연구의 목적은 복부 MRI검사에 유용한 m-DIXON기법이 기존 e-THRIVE기법에 비해 임상적으로 유용한 검사인지 알아보기 위해 2013년 9월부터 2014년 2월까지 간 질환을 주소로 복부 MRI검사를 시행한 84명을 대상으로 분석하였다. 연구결과에서 SNR은 m-DIXON기법 $90.42{\pm}16.90$, e-THRIVE $60.42{\pm}11.54$로 나타났으며, CNR은 m-DIXON기법 $52.38{\pm}22.58$, e-THRIVE기법 $46.31{\pm}20.25$로 나타났다. 정성적 평가는 m-DIXON기법에서 영상의 질 $4.06{\pm}0.34$, 인공물 $3.64{\pm}0.22$, 지방소거 $4.16{\pm}0.15$로 나타났으며, e-THRIVE기법에서 영상의 질 $3.14{\pm}0.35$, 인공물 $3.06{\pm}0.38$, 지방소거 $3.14{\pm}0.30$으로 나타났다. 결론적으로 복부 MRI검사에서 m-DIXON기법은 e-THRIVE 기법에 비해 정량적 평가 및 정성적 평가에서 우수한 것으로 나타나, 향후 복부질환의 진단에 유용하게 활용할 것을 제안한다.

• Advances in pediatric surgery
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• 제2권1호
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• pp.17-25
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• 1996

Acute pancreatitis(AP) in children is not common but can be associated with severe morbidity rates and its diagnosis is often delayed. Thus, reported mortality rates range from 0 to 78%. We have treated 26 patients with AP from 5 to 17 years of age over the past 17 years. We are intended to assess the relevance of the prognostic criteria used to assess severity of adult AP and to review the etiology, clilical presentation, diagnosis, and management of AP in children. The authors retrospectively reviewed 26 children with AP managed in Kyung Hee University Hospital from 1978 to 1995. Among 26 patients with AP, male were 12, and female were 14. And the mean age of patients was 11.8 years. In 9(34.6%), no definitive cause was identified. Common causes of AP were trauma(23.1%) and biliary tract disease(23.1%). Other etiologies were viral infection(15.4%) and post ERCP(3.8%). The presenting features were abdominal pain(92.3%), vomiting(61.5%), fever(19.2%), submandibular pain(11.5%), and abdominal mass(7.6%). Back pain was rare(3.8%). Abdominal ultrasonographic findings were abnormal in 10 of 16 patients(62.5%) and abdominal CT findings were abnormal for 9 of 9 patients(100%). Seventeen patients(65.3%) were managed conservatively, and nine patients(34.6%) required surgical treatment. There was no mortality. To evaluate the severity of disease, we used the Imrie prognostic criteria used to assess the severity in adult AP. The number of positive criteria was correlated to the duration of hospitalization(r2=0.91) but statistically insignificant(p>0.05). But, the number of positive criteria was correlated to the operative incidence(r2=0.93) and statistically significant(p<0.05). The common causes of AP in children were unknown origin(34.6%), trauma(23.1%), and biliary tract disease(23.1%). Ultrasonography and computed tomography were useful imaging tools of AP in children. The Imrie criteria used to evaluate the severity in adult AP were suspected to be valuable to assess the severity of AP in children.

• Tuberculosis and Respiratory Diseases
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• 제70권4호
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• pp.347-351
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• 2011

We report here an unusual case of pericardial tuberculoma that was misdiagnosed as thymic carcinoma on an imaging study. A 48-year-old woman was referred for evaluation of an anterior mediastinal mass. Computed tomography (CT) scans of the chest displayed cystic masses mimicking thymic carcinoma at the anterior mediastinum. Pericardiotomy and surgical drainage of the cystic masses were done, and pathologic examination of the excised pericardial specimen showed a chronic granulomatous inflammation with necrosis, compatible with tuberculosis. Acid-fast bacilli were also identified in the specimen. After treatment with anti-tuberculosis drugs and steroids, the patient showed clinical improvement. Although tuberculous pericarditis usually presents as pericardial effusion or constrictive pericarditis, it can also present as a pericardial mass mimicking thymic carcinoma on CT. Therefore, we suggest that tuberculous pericardial abscess should be included in the differential diagnosis of a mediastinal mass in Korea, with intermediate tuberculosis prevalence.

• Journal of Gastric Cancer
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• 제12권2호
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• pp.99-107
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• 2012

Purpose: Gastric mucosal neoplastic lesions should have characteristic endoscopic features for successful endoscopic submucosal dissection. Materials and Methods: Out of the 1,010 endoscopic submucosal dissection, we enrolled 62 patients that had the procedure cancelled. Retrospectively, whether the reasons for cancelling the endoscopic submucosal dissection were consistent with the indications for an endoscopic submucosal dissection were assessed by analyzing the clinical outcomes of the patients that had the surgery. Results: The cases were divided into two groups; the under-diagnosed group (30 cases; unable to perform an endoscopic submucosal dissection) and the over-diagnosed group (32 cases; unnecessary to perform an endoscopic submucosal dissection), according to the second endoscopic findings, compared with the index conventional white light image. There were six cases in the under-diagnosed group with advanced gastric cancer on the second conventional white light image endoscopy, 17 cases with submucosal invasion on endoscopic ultrasonography findings, 5 cases with a size greater than 3 cm and ulcer, 1 case with diffuse infiltrative endoscopic features, and 1 case with lymph node involvement on computed tomography. A total of 25 patients underwent a gastrectomy to remove a gastric adenocarcinoma. The overall accuracy of the decision to cancel the endoscopic submucosal dissection was 40% (10/25) in the subgroup that had the surgery. Conclusions: The accuracy of the decision to cancel the endoscopic submucosal dissection, after conventional white light image and endoscopic ultrasonography, was low in this study. Other diagnostic options are needed to arrive at an accurate decision on whether to perform a gastric endoscopic submucosal dissection.

• 생명과학회지
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• 제15권4호
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• pp.664-667
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• 2005

척수공동증(hydrosyringomyelia)은 척수내의 중심관(central canal)이 확장되는 질환으로 사람에 있어서는 Dandy-walker 증후군이나 Chiari 기형과 같은 선천적인 기형에 의해 발생되거나 감염, 외상 및 종양과 관련되어서도 발생된다. 뇌수두증(hydrocephalus)은 뇌척수액이 뇌실내에 과도하게 축적되는 것을 말하며 후두골 이형성증(occipital dysplasia)은 후두공이 과도하게 위쪽으로 연장되어 열린 질병이다. 척수공동증과 뇌수두증은 컴퓨터단층촬영이나 자기공명영상 검사에 의해 확진되어질 수 있다. 3세령의 수컷 말티즈가 장기간의 발작 증세를 주증으로 내원하였다. 혈액검사상 특이소견은 없었으나 rostrodorsal-caudoventral oblique의 두개골 방사선 검사에서 심한 두개골 이형성증 소견이 확인되었고 열려진 천문을 통한 초음파 검사상 양측 외측 뇌실이 모두 심하게 확장된 것이 확인되었다. 자기공명영상 검사에서 뇌수두증과 척수공동증이 진단되었다. 이뇨제를 중심으로 한 내과적 처치에 반응을 하지 않아 외과적 감압술(ventriculo-peritoneal shunting)을 시행하였고 현재까지 잘 유지되고 있다. 자기공명영상검사법은 뇌수두증과 척수공동증을 진단하고 그에 따른 치료계획을 수립하며 예후를 평가하는데 있어 가장 우수한 진단 기법이다.

• 한국방사선학회논문지
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• 제7권4호
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• pp.307-311
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• 2013

본 논문에서는 피폭선량 절감을 위해 기존의 선량보다 낮은 선량으로 CT검사를 했을 경우에 병변의 유무를 충분히 가릴 수 있는지 scan parameter(절편두께, Helical Pitch)와 3차원으로 영상재구성시 threshold값의 설정에 따른 영상의 변화정도를 3차원 영상화를 통하여 시료의 체적 변화를 알아보고, 피폭선량절감을 위한 CT에서 허용 가능한 scan parameter를 찾고자 연구를 시도하였다. 실험방법으로는 실리콘을 이용하여 시료를 제작하였으며, 이때 시료의 크기는 직경이 50, 40, 30, 20, 10mm로 10mm 간격으로 5개의 구형 모형을 제작하였고, 5개의 시료를 관전압, 관전류를 각각 120Kvp, 50mA로 고정하고, 단면두께(1.0, 2.0, 3.0, 5.0, 7.0mm), Helical Pitch(1.5, 2.0, 3.0)를 각각 변화시켜 Scan 하고 영상 간의 interval은 (1.0, 2.0, 3.0, 5.0, 7.0mm)로 구성하여, 영상을 workstation으로 전송하고, Volume Rendering Technique를 사용하여 threshold(-200,-50,50 ~1,000) 값을 변화시키면서 3차원 영상으로 재구성하고, 시료의 체적을 측정하였다. 실험결과 Helical pitch가 1.5일 때 체적변화가 가장 적었고, Helical pitch가 3.0일 때 체적변화가 가장 많이 감소하였으며, 절편두께가 증가할수록 시료의 체적도 실측치보다 감소한다는 것을 실험을 통해 확인 할 수 있었다. 또한 3차원 영상재구성시 threshold 범위를 -200~1,000으로 설정한 경우, 시료의 체적의 변화가 가장 적은 것으로 나타났다.