• Title/Summary/Keyword: Head CT

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Traumatic Organized Hematoma Mimicking Intra-peritoneal Tumor : A Case Report (복강내 종양으로 오인된 외상성 혈종: 증례보고)

  • Park, Jong-Min;Kim, Seong Yup;Chung, Il Yong;Kim, Woo-Shik;Shin, Yong-Chul;Kim, Yeong Cheol;Park, Sei Hyeog
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.300-303
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    • 2013
  • Blunt abdominal trauma is commonly encountered in the emergency department. The lack of historical data and the presence of distracting injuries or altered mental status, from head injury or intoxication, can make these injuries difficult to diagnose and manage. We experienced a case of traumatic organized hematoma misdiagnosed as intra-peritoneal tumor with intestinal obstruction. A 52-year-old homeless male patient who have chronic alcoholism was admitted via emergency room with infra-umbilical abdominal pain. At admission, he was drunken status and so we could not be aware of blows to the abdomen. He had a unknown large operation scar on mid abdomen. A computed tomography (CT) scan showed the intestinal obstruction of the ileum level with 5.5cm sized mesenteric tumor. We performed adhesiolysis and widely segmental resection of small bowel including tumor with side-to-side anastomosis due to great discrepancy in size. He stated later that he was a victim of the violence before 3 weeks. A final pathologic report revealed well encapsulated, traumatic mesenteric hematoma with organizing thrombi, ischemia and abscess formation with multiple adhesion bands. Finally, the patient was discharged without complications on postoperative day 14.

Temporomandibular Disorder Caused by Nasopharyngeal Cancer (비인두암종에 의한 측두하악장애)

  • Byun, Young-Sub;Kim, Ki-Seo;Ahn, Hyung-Joon;Choi, Jong-Hoon;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.395-399
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    • 2008
  • Orofacial pain and limited range of mouth opening as symptoms of temporomandibular disorder are mainly triggered by the structural and/or functional changes of temporomandibular joint and related structure itself. But careful diagnostic evaluation should be needed because they may be occurred by another pathologic conditions such as neoplasm in head and neck region. If there would be atypical pain characteristics or clinical features, systemic comorbid symptoms, or poor response to treatment, advanced imaging modalities such as CT or MRI will be mandatory for differential diagnosis. We experienced the case which was diagnosed as nasopharyngeal cancer mimicking temporomandibular disorder, and reviewed clinical considerations for proper differential diagnosis.

Abdominal Injury by Falls from a Height in Children (소아에서 추락사고에 의한 복부손상)

  • Choi, Kum-Ja
    • Advances in pediatric surgery
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    • v.11 no.2
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    • pp.115-122
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    • 2005
  • Falls from a height are the leading cause of injury and death among urban children. This study describes the incidence, clinical characteristics, and treatment results of children under 15 year of age who fell from a height of more than one meter and were admitted for abdominal injury. The medical records of 585 consecutive patients treated between January 1997 and December 2003 at Ewha Womans University Mokdong Hospital were analyzed retrospectively. The falling heights were 1 to 31.2 meters, and 28 patients(4.8 %) suffered from blunt abdominal trauma. The male to female ratio was 2.1: 1. The median age of the victims was 5.5 years, and the median height fallen was 3 meters. Fifteen patients (53.6 %) were injured during the summer and seventy-nine percent of the falls occurred between noon and 9 pm. Eighteen (64.3 %) of falls occurred in residential place and 19(67.8 %) of patients arrived at the emergency department within 30 minutes of the accident. Only 16 patients (57.1 %) complained of abdominal pain. Liver injuries were found in 12(42.9 %), spleen injuries in 5(17.9 %), kidney injuries 3(10.7 %), pancreatic injuries in 1(3.6 %) and nonspecific abdominal injuries in 9(32.1 %) cases. Increased SGOT and SGPT were found in 23(82.2 %) and 18(64.3 %) cases. Eleven patients (39.3 %) had associated head injuries. Limb injuries were present in 17.9% and thoracic injuries in 7.1%. Twenty-five patients (89.3 %) recovered without operation. The median length of hospital stay was 6 days (2 -20 days). Despite the absence of abdominal symptoms or shock, falls from a height in children may carry significant intra-abdominal organ injuries. The height falling could not predict the degree of the abdominal injury. For the evaluation of potential abdominal injuries, CT scan should be utilized.

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Clinical Experiences of Pancreatic Tumors in Children (소아 췌장종양의 임상적 고찰)

  • Im, Ra-Joo;Kim, Hae-Sol;Kim, Tae-Seok;Lee, Cheol-Gu;Seo, Jeong-Meen;Lee, Suk-Koo
    • Advances in pediatric surgery
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    • v.13 no.2
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    • pp.155-161
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    • 2007
  • Pancreatic tumors in children are very rare but have a better prognosis compared with that in adult. Pediatric pancreatic tumors are more often benign and easier to resect. To evaluate the characteristics and prognosis, the records of 13 patients who underwent pancreatic resection, from June 1997 to May 2005, at Samsung Medical Center were reviewed. The mean follow up period was 48 months. The male to female ratio was 1: 1.6. Mean age was 10.3 years. Signs and symptoms included abdominal pain (7), abdominal palpable mass (5), jaundice (1), hypoglycemic (1), and non-specific GI symptoms (4). The commonly used diagnostic tools were CT and abdominal sonography. In addition, MRI, ERCP, EEG, and hormone test were also done when indicated. Surgical procedures included distal pancreatectomy (5), pylorus preserving pancreaticoduodenectomy (4), tumor excision (3), and subtotal pancreatectomy (1). Locations of lesions in pancreas were head (4), tail (5), and body and tail (4). Postoperative complications developed in 3 cases; postoperative ileus (1), wound problem (1), and pancreatitis (1). The pathologic diagnosis included solid-pseudopapillary tumor (6), congenital simple cyst (1), pancreatic duplication cyst (1), serous oligocystic adenoma (1), mucinous cystadenocarcinoma (1), rhabdomyosarcoma (1), insulinoma (1), and pancreatoblastoma (1). Three cases received adjuvant chemotherapy and radiotherapy. Overall survival rate was 81 %. One patient with a mucinous cystadenocarcinoma died. In this study, pancreatic tumors in children were resectable in all patients and had good survival. Surgery of pancreatic tumors should be regarded as the gold standard of treatment and a good prognosis can be anticipated in most cases of benign and malignant tumors.

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A Study on Fracture Toughness of Metal Matrix Composites Reinforced with $Al_{18}B_4O_{33}$ ($Al_{18}B_4O_{33}$휘스커 강화 금속기 복합재료의 파괴인성에 관한 연구)

  • Park, Sung-Ho;Choi, Yong-Bum;Park, Won-Jo;Huh, Sung-Chul;Yun, Han-Gi
    • Proceedings of the Korea Committee for Ocean Resources and Engineering Conference
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    • 2002.10a
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    • pp.335-340
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    • 2002
  • In recent years, the study of metal matrix composite has increased specially, aluminum alloy, research and development are briskly progress to find new metal matrix composite. this study is following the this purpose; This study is used metal matrix composite that was produced by matrix, AC4CH. and reinforcement $A_{18}B_4O_{33}$ metal matrix composite to add $Al_2O_3,\;TiO_2$ for strengthen of binding together among the Whisker. Each Metal matrix composite is produced using the squeeze casting method. Fracture tounghness test was in accordance with the provisions of ASTM E399; Specimen was produced half-size CT specimen W=25mm, B=12.5mm, Cross head speed 0.05mm/min in room temperature. The plane strain fracture toughness $K_{IC}$ is $8.7MPa-m^{0.5}$ for $Al_{18}B_4O_{33}$/AC4CH., $9.28MPa-m^{0.5}$ for $Al_{18}B_4O_{33}$/AC4CH added $TiO_2$. and $Al_2O_3$ but AC4CH alloy was violated the critical stipulated by ASTM standard for a valid measurement of $K_{IC}$. In case of, it was performed $I_{IC}$ test instead of $K_{IC}$ based on ASTM E 1820

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A Case of Group F Streptococcal Bacteremia in MPGN Patient (막 증식성 사구체 신염 환아에서 발생한 F군 연구균 혈증 1례)

  • Chung, Ji-Young;Moon, Soon-Chung;Cho, Byoung-Su;Cha, Seong-Ho;Lee, Hee-Joo
    • Pediatric Infection and Vaccine
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    • v.9 no.1
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    • pp.100-103
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    • 2002
  • Streptococcus milleri Goup Bacteria(SMG) comprise three species, Streptococcus anginosus, Streptococcus intermedius, Streptococcus constellatus. Although they are commensal organism, they can be pathogenic. SMG can be aggressive pathogen in the head and neck with a propensity for abscess formation and local extension of the infection. SMG is culturally and biochemically variable, which makes it hard for the clinicians to recognize it. Hence, it seems that this organism has been relatively neglected. Most of the Lancefield F streptococci are SMG. We report one patient who had Group F streptococcal bacteremia and subdural abscess. According to his medical history, he was diagnosed as membranoproliperative glomerulonephritis three years ago. He complained headache although he was treated by appropiate antibiotics. Brain CT was used as a tool to identify the brain abscess. He had surgical drainage and was treated with IV antibiotics postoperatively.

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A Comparison between Three Dimensional Radiation Therapy and Intensity Modulated Radiation Therapy on Prostate Cancer (전립샘암의 방사선 치료 시 입체조형치료법와 세기조절방사선 치료법의 비교)

  • Kim, YoungJae;Lee, JaeSub;Hong, Seongill;Ko, HyeJin
    • Journal of the Korean Society of Radiology
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    • v.7 no.6
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    • pp.409-414
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    • 2013
  • In this study, we evaluated to the superiority of treatment techniques on prostate cancer, apply to each other treatment techniques-3D conformal therapy versus IMRT-using dose distribution and dose coverages. Obtained 10 patients CT simulation, divided tumor volume and critical organs. Prescription dose was 80 Gy on tumor volume and Each of plans was set by two different plans. As a result, Dose coverage was superior to IMRT. The IMRT's tumor absorbed dose(100.2%) was close to prescription doses. Normal tissue(bladder, rectal, bowel Lt Rt fumoral head) absorbed dose rate was superior. In other words, the radiation therapy of prostate cancer with intensity modulated radiation therapy was better than conformal radiation therapy on dose.

Application of Finite Element Analysis for Structural Stability Evaluation of Modern and Contemporary Sculptures: 'Eve 58-1' by Man Lin Choi

  • Kwon, Hee Hong;Shin, Jeong Ah;Cho, Nam Chul
    • Journal of Conservation Science
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    • v.38 no.4
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    • pp.277-288
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    • 2022
  • 'Eve 58-1', the subject of this study is a statue made of plaster and its structural stability was evaluated by utilizing the CAE program in order to prevent the risk of damage arising from impact and vibration that are generated during the packaging and transportation process given its material characteristics. CAE is an abbreviation for Computer Applied Engineering for realization by predicting changes at the time of application of virtual physical energy. It is applied by reflecting the physical property conditions and each boundary condition of plaster, and the digital images of the internal and external structure of the work were acquired through 3D scanning and CT analysis for interpretation by executing finite element modeling. When acceleration is applied to the work in the direction of its own weight, the left-right side and the front-rear side, it was possible to confirm a maximum displacement value of 15.24 mm in the head section of the front-rear side direction that has been tilted by approximately 27° from the Y-axis and the largest stress value of 12.46 MPa was at the left ankle section. The corresponding results confirmed that the left ankle section is the most vulnerable area and the section for which precautions need to be exercised and supplemented at the time of transporting the work by means of objective values.

Usefulness of Non-coplanar Helical Tomotherapy Using Variable Axis Baseplate (Variable Axis Baseplate를 이용한 Non-coplanar 토모테라피의 유용성)

  • Ha, Jin-Sook;Chung, Yoon-Sun;Lee, Ik-Jae;Shin, Dong-Bong;Kim, Jong-Dae;Kim, Sei-Joon;Jeon, Mi-Jin;Cho, Yoon-Jin;Kim, Ki-Kwang;Lee, Seul-Bee
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.31-39
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    • 2011
  • Purpose: Helical Tomotherapy allows only coplanar beam delivery because it does not allow couch rotation. We investigated a method to introduce non-coplanar beam by tilting a patient's head for Tomotherapy. The aim of this study was to compare intrafractional movement during Tomotherapy between coplanar and non-coplanar patient's setup. Materials and Methods: Helical Tomotherapy was used for treating eight patients with intracranial tumor. The subjects were divided into three groups: one group (coplanar) of 2 patients who lay on S-plate with supine position and wore thermoplastic mask for immobilizing the head, second group (non-coplanar) of 3 patients who lay on S-plate with supine position and whose head was tilted with Variable Axis Baseplate and wore thermoplastic mask, and third group (non-coplanar plus mouthpiece) of 3 patients whose head was tilted and wore a mouthpiece immobilization device and thermoplastic mask. The patients were treated with Tomotherapy after treatment planning with Tomotherapy Planning System. Megavoltage computed tomography (MVCT) was performed before and after treatment, and the intrafractional error was measured with lateral(X), longitudinal(Y), vertical(Z) direction movements and vector ($\sqrt{x^2+y^2+z^2}$) value for assessing overall movement. Results: Intrafractional error was compared among three groups by taking the error of MVCT taken after the treatment. As the correction values (X, Y, Z) between MVCT image taken after treatment and CT-simulation image are close to zero, the patient movement is small. When the mean values of movement of each direction for non-coplanar setup were compared with coplanar setup group, X-axis movement was decreased by 13%, but Y-axis and Z-axis movement were increased by 109% and 88%, respectively. Movements of Y-axis and Z-axis with non-coplanar setup were relatively greater than that of X-axis since a tilted head tended to slip down. The mean of X-axis movement of the group who used a mouthpiece was greater by 9.4% than the group who did not use, but the mean of Y-axis movement was lower by at least 64%, and the mean of Z-axis was lower by at least 67%, and the mean of Z-axis was lower by at least 67%, and the vector was lower by at least 59% with the use of a mouthpiece. Among these 8 patients, one patient whose tumor was located on left frontal lobe and left basal ganglia received reduced radiation dose of 38% in right eye, 23% in left eye, 30% in optic chiasm, 27% in brain stem, and 8% in normal brain with non-coplanar method. Conclusion: Tomotherapy only allows coplanar delivery of IMRT treatment. To complement this shortcoming, Tomotherapy can be used with non-coplanar method by artificially tilting the patient's head and using an oral immobilization instrument to minimize the movement of patient, when intracranial tumor locates near critical organs or has to be treated with high dose radiation.

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The Evaluation of Composite Dose using Deformable Image Registration in Adaptive Radiotherapy for Head and Neck Cancer (두경부 종양의 적응방사선치료시 변형영상정합을 이용한 합성선량 평가)

  • Hwang, Chul-Hwan;Ko, Seong-Jin;Kim, Chang-Soo;Kim, Jung-Hoon;Kim, Dong-Hyun;Choi, Seok-Yoon;Ye, Soo-Young;Kang, Se-Sik
    • Journal of radiological science and technology
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    • v.36 no.3
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    • pp.227-235
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    • 2013
  • In adaptive radiotherapy(ART), generated composite dose of surrounding normal tissue on overall treatment course which is using deformable image registration from multistage images. Also, compared with doses summed by each treatment plan and clinical significance is considered. From the first of May, 2011 to the last of July, 2012. Patients who were given treatment and had the head and neck cancer with 3-dimension conformal radiotherapy or intensity modulated radiotherapy, those who were carried out adaptive radiotherapy cause of tumor shrinkage and weight loss. Generated composite dose of surrounding normal tissue using deformable image registration was been possible, statistically significant difference was showed to mandible($48.95{\pm}3.89$ vs $49.10{\pm}3.55$ Gy), oral cavity($36.93{\pm}4.03$ vs $38.97{\pm}5.08$ Gy), parotid gland($35.71{\pm}6.22$ vs $36.12{\pm}6.70$ Gy) and temporomandibular joint($18.41{\pm}9.60$ vs $20.13{\pm}10.42$ Gy) compared with doses summed by each treatment plan. The results of this study show significant difference between composite dose by deformable image registration and doses summed by each treatment plan, composite dose by deformable image registration may generate more exact evaluation to surrounding normal tissue in adaptive radiotherapy.