• Title/Summary/Keyword: Head and neck.

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Case of Treatment Using Adaptive Servo-Ventilation in a Patient with Central Sleep Apnea after a Lateral Medullary Infarction (외측 연수 경색에 의해 발생한 중추성 수면 무호흡 환자의 자동-적응형 양압기를 사용하여 치료한 경험)

  • Kim, Dae Jin;Cho, Jae Wook;Kim, Hyun Woo;Choi, Jeong Su;Mun, Sue Jean
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.3
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    • pp.278-283
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    • 2020
  • Central sleep apnea (CSA) is characterized by respiratory failure of at least 10 seconds without any effort of the chest and abdomen in the absence of upper airway resistance during sleep. In this case, the patient experiences respiratory failure that does not meet the CSA diagnostic criteria and CSA symptoms. Magnetic resonance imaging diffusion-weighted imaging (MRI DWI) scans revealed a lateral medullary infarction. Continuous positive airway pressure (CPAP) was applied as a primary treatment for CSA and respiratory failure. During the titration of CPAP, the apnea-hypopnea index (AHI) and arousal index (AI) were worse than the results before its use (AHI: 42.5/hr→82.8/hr, AI: 21.7/hr→40.8h). As a result, adaptive servo-ventilation (ASV) was chosen as the secondary treatment. Compared to the night-polysomnography results before the ASV treatment, the AHI improved (42.5/hr→8.6/hr). Therefore, ASV is a potential treatment for CSA and respiratory failure in these patients.

Formulation of a reference coordinate system of three-dimensional (3D) head & neck images: Part I. Reproducibility of 3D cephalometric landmarks (3차원 두부영상의 기준좌표계 설정을 위한 연구: 1부 CT영상에서 3차원 계측점의 재현성)

  • Park, Jae-Woo;Kim, Nam-Kug;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.35 no.5 s.112
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    • pp.388-397
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    • 2005
  • The purpose of this study was to redefine the cephalometric landmarks in three-dimensional (3D) images, which are used in orthodontic cephalometric radiography, and to evaluate the reproducibility of each landmark for 3D cephalometric analysis. Eighteen CT scans were taken at the Department of Diagnostic Radiology at Seoul National University Dental Hospital and manipulated with V works 4.0(Cybermed Inc., Seoul, Korea). The coordinate system was established using 7 reference points, with no more than 4 points on the same plane. These 7 points were generated as a volume model, the voxel size of which was 4 by 4 by 2 (threshold value=639). The cephalometric landmarks were selected at the multiplanar reformation (MPR) window on the volume mode of V works 4.0. The selected landmarks were exported to V surgery (Cybermed Inc., Seoul, Korea) for the calculation of coordinate values. All the data were taken twice with a lapse of 2 weeks by one investigator The reproducibility of each landmark was $0.17\~1.21mm$ in the x axis, $0.30\~1.53mm$. In the y axis, and $0.27\~1.81mm$ in the z axis. In all three axes, the range of error was similar. These error ranges were acceptable with regards to the pixel space and slice thickness. The most reproducible points were 1 points which were selected on the basis of the volume model. The least reproducible points were J points that were defined by sutures.

Immunoglobulin G4-Related Disease Involving the Pterygopalatine Fossa, Mimicking Invasive Aspergillosis: A Case Report and Literature Review (침습아스페르길루스증으로 오인된 날개입천장오목에 발생한 면역글로불린 G4 관련 질환: 증례 보고 및 문헌 고찰)

  • Jin Young Son;Jee Young Kim;Jin Hee Cho;Eun Jung Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.1005-1010
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    • 2021
  • We report a case of Immunoglobulin G4 (IgG4) related disease involving the pterygoplataine fossa. A 83-year-old male presented with left ocular pain and visual disturbance. CT showed an isodense soft tissue lesion in the left pterygopalatine fossa with bony sclerotic changes and erosion. MRI revealed an infiltrative soft tissue mass in the left pterygopalatine fossa as a T2 slightly low signal intensity and heterogeneous enhancement. The patient underwent left ethmoidectomy, and biopsy of the mass was conducted. The histopathological diagnosis was IgG4-related disease. In this case, it was difficult to differentiate invasive aspergillosis, which is common in immunocompromised patients, considering the patient's clinical history of diabetes mellitus. This report describes the imaging findings of IgG4-related disease mimicking invasive sinusitis such as invasive aspergillosis.

Technical Review of Target Volume Delineation on the Posterior Fossa Tumor : An Optimal Head and Neck Position (후두와 종양의 방사선치료 시 표적용적의 결정을 위한 적절한 치료자세 연구)

  • Yoon Sang Min;Lee Sang-wook;Ahn Seung Do;Kim Jong Hoon;YE Byong Yong;Ra Young Shin;Kim Tae Hyung;Choi Eun Kyung
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.94-99
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    • 2003
  • Purpose : To explore a 3D conformal radiotherapy technique for a posterior fossa boost, and the potential advantages of a prone position for such radiotherapy. Materials and Methods :A CT simulator and 3D conformal radiotherapy Planning system was used for the posterior fossa boost treatment on a 13-year-old medulloblastoma patient. He was placed In the prone position and Immobilized with an aquaplast mask and immobilization mold. CT scans were obtained of the brain from the top of the skull to the lower neck, with IV contrast enhancement. The target volume and normal structures were delineated on each slice, with treatment planning peformed using non-coplanar conformal beams. Results : The CT scans, and treatment In the prone position, were peformed successfully. In the prone position, the definition of the target volume was made easier due to the well enhanced tentorium, In audition, the posterior fossa was located anteriorly, and with the greater choice of beam arrangements, more accurate treatment planning was possible as the primary beams were not obstructed by the treatment table. Conclusion : .A posterior fossa boost, in the prone position, Is feasible in cooperating patients, but further evaluation is needed to define the optimal and most comfortable treatment positions.

Production of Organic Rice (Oryza sativa L.) using Organic Cultivation Manual (유기재배매뉴얼을 활용한 유기쌀 생산)

  • Cha, Kwang-Hong;Oh, Hwan-Jung;Seo, Dong-Jun;Song, Yong-Su;Ahn, Joon-Seob;An, Kyu-Nam;Jung, Woo-Jin
    • Korean Journal of Organic Agriculture
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    • v.22 no.1
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    • pp.97-113
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    • 2014
  • An actual proof experiment was carried out to establish the production of high quality organic rice at farm household in Gwangjin, Junnam, Korea 2011. Experimental plot was designed with conventional organic cultivation and manual organic cultivation in both Hopeongbyeo and Onnuri varities. Experimental field was consisted with suitable drainage loam soil, anryong series, and normal paddy field. Chemical characteristics of the soil were investigated from initial soil and soil after harvest in experimental sites. Seed disinfection was treated with hot water dipping method at $60^{\circ}C$ for 10 min. Rice transplanting was carried out at 17 June with 25 days seedling using machine transplanting. Golden apple snail was used to prevent weed growth as middle size (1.5~1.7 kg/10a) at one week after rice transplanting. Amount of applied fertilizer in experimental plot was supplied with organic fertilizer for the shortage after harvest of hairy vetch (1,100 kg/10a). Bordeaux mixture was used to control of sheath blight and neck blast disease in all experimental plot at 19 Aug. Application of chitin culture solution was treated in manual organic cultivation at 2 and 15 Aug. At late growth stage, incidence rate of neck blast was the highest level at Hopyeongbyeo in conventional organic cultivation. Incidence rate of sheath blight in both Hopyeongbyeo and Onnuri was higher in conventional organic cultivation than in manual organic cultivation. Incidence of rice leaf folder was the highest level at Onnuri in conventional organic cultivation. Yield index in manual organic cultivation was increased by 13% and 38% at Onnuri and Hopyeongbyeo, respectively, compared with conventional organic cultivation. Head rice percentage in both Hopyeongbyeo and Onnuri was slightly increased in manual organic cultivation. These results indicate that high quality production of rice organic cultivation could be depending on management of safe fertilization with nutrient content in soil.

Spinal Cord Partial Block Technique Using Dynamic MLC (동적 다엽콜리메이터를 이용한 척수의 부분 차폐 기법)

  • 조삼주;이병용;이상욱;안승도;김종훈;권수일;최은경
    • Progress in Medical Physics
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    • v.14 no.1
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    • pp.8-14
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    • 2003
  • The spinal cord dose is the one of the limiting factor for the radiation treatment of the head & neck or the thorax region. It is not an easy task to maintain the spinal cord dose below tolerance and to keep the clinically acceptable dose to the PTV in this region. To overcome this problem, the spinal cord partial block technique (PBT) with the dynamic Multi-Leaf Collimator (dMLC) has been developed. This technique is an extension of the conventional treatment planning. In the beginning the beam directions are selected as same as the conventional treatment planning to encompass the PTV, then the partial block are designed to shield the spinal cord. The plan comparisons between the conventional therapy plan and the PTB plan were performed to evaluate the validity of this technique. The mean dose and the dose volume histogram (DVH) were used as the plan comparison indices. A series of quality assurance (QA) was performed to guarantee the reliable treatment. The QA consisted of the film dosimetry for the verification of the dose distribution and the point measurements. The PBT plan generated better results than the conventional treatment plan and it was proved to be useful for the H&N region.

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A case of postoperative nasopharyngeal reflux associated with retropharyngeal lymphangioma in newborn infant (수술 후 비인두 역류가 동반된 신생아의 후인두림프관종 1례)

  • Koo, Kyo Yeon;Lee, Jun Seok;Lee, Soon Min;Park, Min Soo;Namgung, Ran;Park, Kook In;Lee, Chul;Yoon, Choon Sik;Jung, Woo Hee;Choi,, Hong Shik
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.258-261
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    • 2010
  • Lymphangioma is a rare benign congenital tumor of the lymphatic system, which is commonly diagnosed before 2 years of age. In the natronal report, cystic lymphangioma was usually reported as a huge translucent mass located in the head and neck area. It's occurrence in retropharyngeal space with respiratory obstruction and swallowing difficulty in neonate is extremely rare and postoperative nasopharyngeal reflux has rarely been reported. Complete resection is the standard therapy. However, involvement of the upper airway may be determining prognosis in the extensive lymphangiomas because of the difficulty of complete excision. We present a case of cystic lymphangioma in neonate which was initially asymptomatic but gradually progressed to cause respiratory obstruction due to enlargement. After resection, nasopharyngeal reflux developed with dysfunction of the soft palate and gradually improved with conservative care over 5 months.

Medical Characteristics of the Elderly Pedestrian Inpatient in Traffic Accident (노인 보행자 운수사고 입원환자의 의료적 특성연구)

  • Park, Hye-Seon;Kim, Sang-Mi
    • Journal of Digital Convergence
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    • v.17 no.12
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    • pp.345-352
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    • 2019
  • This study aims to analyze the factors affecting the length of stay in elderly pediatric inpatients in traffic accidents. We used Korean National Hospital Discharge In-depth Injury data on the discharged from 2012 to 2016. Statistically significant factors affecting the length of stay are admission route, Charlson Comorbidity Index(CCI), injury parts, operation, results, hospital area, and beds for hospitals. The length of stay was shorter in the case of the admission route of the outpatient department than the emergency room, the results were not improved or death rather than improved, and the bed size was 500-999 beds or over 1000 beds rather than 100-299 beds. However, the length of stay was longer in the case of CCI score was 1-2 or over 3 rather than 0, injury parts were other parts rather than head/neck, when the operation was yes, and when the hospital area was a province, metropolitan rather than Seoul. This study intends to understand the medical characteristics of inpatient to prevent pedestrian traffic accidents in accordance with the population aging. Based on this finding, we wish to be used as the basic data for the establishment of policies to effectively manage traffic safety and medical resources in consideration of the characteristics of the elderly people.

Operative treatment for Proximal Humeral Fracture (상완골 근위부 골절의 수술적 요법)

  • Park Jin-Young;Park Hee-Gon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.168-175
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    • 2003
  • Fracture about proximal humerus may be classified as the articular segment or the anatomical neck, the greater tuberosity, the lesser tuberosity, and the shaft or surgical neck. Now, usually used, Neer's classification is based on the number of segments displaced, over 1cm of displaced or more than 45 degrees of angulation , rather than the number of fracture line . Absolute indication of a operative treatment a open fracture, the fracture with vascular injury or nerve injury , and unreductable fracture-dislocation . Inversely, the case that are severe osteoporosis, and eldly patient who can't be operated by strong internal fixation is better than arthroplasty used by primary prosthetic replacement and early rehabilitation program than open reduction and internal fixation. The operator make a decision for the patient who should be taken the open reduction and internal fixation, because it's different that anatomical morphology, bone density, condition of patient. The operator decide operation procedure. For example, percutaneous pinning, open reduction, plate & screws, wire tension bands combined with some intramedullary device are operation procedure that operator can decide . The poor health condition for other health problem, fracture with unstable vital sign and severe osteoporosis , are the relative contraindication. The stable fracture without dislocation is not the operative indication . The radiologic film of the prokimal humerus before the operation can not predict for fracture evaluation. It's necessary to good radiologic film for evaluation of fracture form. The trauma serise is better than the other radiologic film for evaluation. The accessary radiologic exam is able to help for evaluation of bone fragment and anatomy. The CT can be helpful in evaluating these injury, especially if the extract fracture type cannot be determined from plain roenterogram of the proximal humerus, bone of humerus head. If the dislocation is severe anatomically , we could consider to do three dimentional remodelling. The MRI doing for observing of bony morphology before the operation is not better than CT If we were suspicious of vascular injury, we could consider the angiography.

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A Preliminary Study of Virtual-micro Intensity Modulated Radiation Therapy (가상 미세 세기조절방사선치료(Virtual micro-IMRT;VMIMRT) 기법의 임상 적용을 위한 예비적 연구)

  • 김상노;조병철;서택석;배훈식;최보영;이형구
    • Progress in Medical Physics
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    • v.13 no.1
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    • pp.32-36
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    • 2002
  • For Intensity Modulated Radiation Therapy(IMRT), the spatial resolution of intensity map(IM) is limited by the width of multi-leaf collimator, which would make an effect on the conformity of the target, as well as organs at risk. Several Methods are suggested to increase the spatial resolution, which can be categorized by the hardware-dependent technique and the software-based technique. However the best solution might be to make the width of MLC finer. it has several obstacles in the respects of technical difficulty and cost. This preliminary study is designed to investigate the clinical effectiveness of the virtual-micro IMRT(VMIMRT) technique, one of the software-based technique. A particular intensity map was created, which has 42$\times$54 pixel dimension ,0.5cm pixel size and 15 intensity levels. Using this intensity map, segment fields of IMRT were generated with 1$\times$lcm, 0.5$\times$1cm, 0.5$\times$0.5cm(VMIM) beamlet size, respectively As results, we found that there was no evidence of improvement for VMIMRT, compared with the 0.5$\times$lcm beamlet size which can be delivered by 1cm width MLC. The reason seems to be due to the constraint of VMIMRT. Further study is required to prove the benefit of the VIMRT in clinical case like head and neck cancer, where is expected that higher resolution than 1cm is necessary.

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