• Infection and chemotherapy
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• v.50 no.4
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• pp.350-356
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• 2018

In acquired immunodeficiency syndrome (AIDS) patients, immune reconstitution inflammatory syndrome (IRIS) due to Mycobacterium avium complex (MAC) infection is one of the most difficult IRIS types to manage. We report an unusual case of MAC-associated IRIS. At first the patient was diagnosed human immunodeficiency virus (HIV) infection after he was admitted with pneumocystis pneumonia. After starting antiretroviral therapy he presented unmasked IRIS with MAC infection. Next, he was hospitalized with continuous loose stools and new-onset fever. Investigation included computed tomography (CT), which showed homogeneous enhancement and enlargement of the lymph nodes (LN), elevation of ferritin (>1,650 ng/mL) and lactate dehydrogenase (306 IU/L) levels, and F- fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scan, which showed increased FDG uptake. These findings were highly indicative of lymphoma. We performed laparoscopic biopsy of the mesenteric LN, and the biopsy culture grew MAC. So we made a diagnosis of MAC-associated. Therefore, IRIS must be considered as a possible diagnosis when AIDS patients develop new symptoms or exhibit exacerbations of existing symptoms. Furthermore the biopsies should be conducted.

• Korean Journal of Veterinary Research
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• v.64 no.2
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• pp.15.1-15.5
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• 2024

A 13-year-old, Maltese dog presented with syncope and lethargy. Abdominal ultrasonography demonstrated anechoic peritoneal effusion and hepatic congestion. A focal echogenic round mass compressing the right ventricle and atrium was observed on echocardiography. Cardiac tamponade and right ventricular outflow tract obstruction occurred. On computed tomography, a homogeneous soft-tissue structure compressing the right chamber without contrast enhancement, suspected to be loculated pericardial effusion. During pericardiocentesis, cardiac tamponade was resolved, and irregular pericardial thickening was noted. Pericardial effusion was exudate and gram-positive bacterial colonies were observed on cytology. A diagnosis of fibrinous pericarditis secondary to bacterial infection was established.

• The korean journal of orthodontics
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• v.46 no.3
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• pp.163-170
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• 2016

Objective: The aims of this study were to investigate a simple method for assessing anterior-posterior jaw relationships via cone-beam computed tomography (CBCT) images taken in the natural head position (NHP) relative to the nasion true vertical plane (NTVP), and measure normative data in Korean adults with normal profiles. Methods: Subjects were selected from patients presenting for third molar extraction and evaluated as having normal profiles by three examiners. The CBCT images of 80 subjects (39 males, 41 females) were taken in the NHP according to Solow and Tallgren's method. Linear measurements of the A-point, B-point, and Pog were calculated relative to the NTVP. Student's t -test was used to assess sexual differences in these measurements. Results: The mean linear measurements of the A-point, B-point, and Pog relative to the NTVP were 0.18 mm (standard deviation [SD], 4.77 mm), -4.00 mm (SD, 6.62 mm), and -2.49 mm (SD, 7.14 mm) respectively in Korean males, and 1.48 mm (SD, 4.21 mm), -4.07 mm (SD, 6.70 mm) and -2.91 mm (SD, 7.25 mm) in Korean females respectively. There were no statistically significant differences between Korean males and females (p < 0.05). Conclusions: Three-dimensional CBCT analysis using the NTVP is a simple and reliable method for assessing anterior-posterior skeletal relationships.

• Journal of Cardiovascular Imaging
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• v.26 no.4
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• pp.238-246
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• 2018

BACKGROUND: Kawasaki disease (KD) sometimes presents with only fever and cervical lymphadenopathy before other clinical signs materialize. This lymphadenopathy-first-presenting Kawasaki disease (LKD) may be misdiagnosed as bacterial cervical lymphadenitis (BCL). We investigated characteristic imaging and clinical data for factors differentiating LKD from BCL. METHODS: We compared imaging, clinical, and laboratory data of patients with KD and BCL. We included patients admitted to a single tertiary center between January 2015 and July 2018. RESULTS: We evaluated data from 51 patients with LKD, 63 with BCL, and 218 with typical KD. Ultrasound imaging revealed multiple enlarged lymph nodes in both LKD and BCL patients. On the other hand, computed tomography (CT) showed more abscesses in patients with BCL. Patients with LKD were younger and showed higher systemic and hepatobiliary inflammatory markers and pyuria than BCL patients. In multivariable logistic regression, younger age and higher C-reactive protein (CRP) retained independent associations with LKD. A comparison of the echocardiographic findings in LKD and typical KD showed that patients with LKD did not have a higher incidence of coronary artery abnormalities (CAA). CONCLUSIONS: LKD patients tend to have no abscesses on CT and more elevated systemic hepatobiliary inflammatory markers and pyuria compared to BCL patients. The absence of abscess on CT, younger age, and elevated CRP were the most significant variables differentiating LKD from BCL. There was no difference in CAA between LKD and typical KD.

• Korean Journal of Radiology
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• v.25 no.6
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• pp.518-539
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• 2024

Coronary computed tomography angiography (CCTA) has emerged as a pivotal tool for diagnosing and risk-stratifying patients with suspected coronary artery disease (CAD). Recent advancements in image analysis and artificial intelligence (AI) techniques have enabled the comprehensive quantitative analysis of coronary atherosclerosis. Fully quantitative assessments of coronary stenosis and lumen attenuation have improved the accuracy of assessing stenosis severity and predicting hemodynamically significant lesions. In addition to stenosis evaluation, quantitative plaque analysis plays a crucial role in predicting and monitoring CAD progression. Studies have demonstrated that the quantitative assessment of plaque subtypes based on CT attenuation provides a nuanced understanding of plaque characteristics and their association with cardiovascular events. Quantitative analysis of serial CCTA scans offers a unique perspective on the impact of medical therapies on plaque modification. However, challenges such as time-intensive analyses and variability in software platforms still need to be addressed for broader clinical implementation. The paradigm of CCTA has shifted towards comprehensive quantitative plaque analysis facilitated by technological advancements. As these methods continue to evolve, their integration into routine clinical practice has the potential to enhance risk assessment and guide individualized patient management. This article reviews the evolving landscape of quantitative plaque analysis in CCTA and explores its applications and limitations.

• Investigative Magnetic Resonance Imaging
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• v.25 no.2
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• pp.109-117
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• 2021

Purpose: To investigate the reliability of CT and MRI for quantitative and qualitative analyses of lumbar paraspinal muscle fatty infiltration (PSFI) and correlation of PSFI with intervertebral disc pathology. Materials and Methods: Lumbar spine CT and MRI of 36 subjects were reviewed retrospectively. Two observers independently outlined lumbar paraspinal muscles at each mid-intervertebral disc level. Paraspinal muscles on CT and MRI were graded according to the Goutallier grading system (GGS). The area, mean value, and standard deviation (SD) of the Hounsfield unit (HU) were obtained. Intervertebral discs were assessed on axial image of T2WI at each level. Correlations between qualitative and quantitative data and intervertebral disc pathology, age, and sex were evaluated. Results: Inter- and intra-observer agreements for results of GGS on MRI were substantial (κ = 0.79) and moderate (κ = 0.59), respectively. Inter- and intra-observer agreements for results of GGS on CT were almost perfect (κ = 0.88) and substantial (κ = 0.66), respectively. Quantitative measurements of HU showed almost perfect inter- and intra-observer reliabilities (κ = 0.82 and κ = 0.99, respectively). There were statistically significant correlations between intervertebral disc pathology and PSFI at L1-2, L2-3, and L4-5 levels on MRI and at L1-2 and L3-4 levels on CT. Age showed significant correlation with results of GGS at all levels on CT and MRI. Conclusion: This study showed that GGS results and HU measurements could be useful for evaluating PSFI because they showed correlations with intervertebral disc pathology results at certain levels.

• Journal of Chest Surgery
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• v.50 no.4
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• pp.308-311
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• 2017

A 71-year-old man was referred for an anterior chest wall mass. Chest computed tomography (CT) and positron emission tomography-CT suggested a malignant tumor. Surgical biopsy through a vertical subxiphoid incision revealed an extra-gastrointestinal stromal tumor (EGIST). En bloc resection of the tumor, including partial resection of the sternum, costal cartilage, pericardium, diaphragm, and peritoneum, was performed. Pathologic evaluation revealed a negative resection margin and confirmed the tumor as an EGIST. On postoperative day 17, the patient was discharged without any complications. At the 2-week follow-up, the patient was doing well and was asymptomatic.

• The Journal of Internal Korean Medicine
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• v.39 no.4
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• pp.764-771
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• 2018

The purpose of this study was to investigate the cases diagnosed as subarachnoid hemorrhage by noncontrast computed tomography (NCCT) after the appearance of symptoms related to headache and paralysis in patients who visited a Korean medicine hospital. A search of electronic medical records of patients diagnosed with subarachnoid hemorrhage on NCCT in W Korean medicine hospital from January 2010 to December 2017 identified five patients. The patients (four women and one man) ranged in age from 64 to 79 years old. Three were inpatients and two were outpatients. Two patients had hypertension, two patients had diabetes, two patients had heart disease, and two patients had a history of cerebral infarction. Development of a cooperative system is needed for accurate diagnosis and appropriate treatment of this disease in the Korean medicine clinic and for establishment of an NCCT scan application method.

• Korean Journal of Radiology
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• v.21 no.7
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• pp.838-850
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• 2020

Computed tomography (CT) is an important imaging modality in evaluating thoracic malignancies. The clinical utility of dual-energy spectral computed tomography (DESCT) has recently been realized. DESCT allows for virtual monoenergetic or monochromatic imaging, virtual non-contrast or unenhanced imaging, iodine concentration measurement, and effective atomic number (Z_eff map). The application of information gained using this technique in the field of thoracic oncology is important, and therefore many studies have been conducted to explore the use of DESCT in the evaluation and management of thoracic malignancies. Here we summarize and review recent DESCT studies on clinical applications related to thoracic oncology.

• Journal of Korean Neurosurgical Society
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• v.58 no.2
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• pp.131-136
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• 2015

Objective : To investigate the incidence of corpus callosum injury (CCI) in patients with mild traumatic brain injury (TBI) using brain MRI. We also performed a review of the clinical characteristics associated with this injury. Methods : A total of 356 patients in the study were diagnosed with TBI, with 94 patients classified as having mild TBI. We included patients with mild TBI for further evaluation if they had normal findings via brain computed tomography (CT) scans and also underwent brain MRI in the acute phase following trauma. As assessed by brain MRI, CCI was defined as a high-signal lesion in T2 sagittal images and a corresponding low-signal lesion as determined by axial gradient echo (GRE) imaging. Based on these criteria, we divided patients into two groups for further analysis : Group I (TBI patients with CCI) and Group II (TBI patients without CCI). Results : A total of 56 patients were enrolled in this study (including 16 patients in Group I and 40 patients in Group II). Analysis of clinical symptoms revealed a significant difference in headache severity between groups. Over 50% of patients in Group I experienced prolonged neurological symptoms including dizziness and gait disturbance and were more common in Group I than Group II (dizziness : 37 and 12% in Groups I and II, respectively; gait disturbance : 12 and 0% in Groups I and II, respectively). Conclusion : The incidence of CCI in patients with mild TBI was approximately 29%. We suggest that brain MRI is a useful method to reveal the cause of persistent symptoms and predict clinical prognosis.