• 한국정보전자통신기술학회논문지
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• 제9권2호
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• pp.196-204
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• 2016

세계보건기구협회에의 통계에 따르면 심장 혈관 질환의 발병률이 가장 높은 것으로 알려져 있다. CTA영상을 사용하여 관상동맥 및 대동맥 질환을 치료 및 검사할 수 있다. 혈관을 3차원으로 복원하는 과정이 의사의 숙련도에 따라 결과가 상이하며 복원 시간이 길다는 단점이 있으며 이를 극복하고자 자동으로 정확한 혈관을 추출하는 연구들이 진행되어 왔다. 본 논문에서는 자동 및 반자동 분할 기법인 Region Competition, Geodesic Active Contour(GAC), Multi-atlas based segmentation, Active Shape Model(ASM) 알고리즘을 CTA영상에 적용하여 대동맥 기부를 추출하였으며 하우스도르프 거리, 볼륨, 영상처리속도, 사용자 관여 여부, 그리고 관상동맥 심문 검출률을 비교 및 분석하였다. 추출된 3차원 대동맥 모델 중 가장 높은 정확도를 나타낸 알고리즘은 GAC인 반면 사용자 관여가 가장 높았기 때문에 실제 시술에 적용하기 위해서는 자동 분할 알고리즘 개선이 필요하다

• 한국방사선학회논문지
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• 제3권2호
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• pp.5-10
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• 2009

심근영상의 SPECT(Single Photon Emission Computed tomography)검사는 감마선을 방출하는 방사성의약품을 환자에게 정맥주사한 후 이 의약품이 심장에 고루 퍼지면 관심부위를 촬영하여 질병으로 인한 변화를 컴퓨터를 이용하여 진단하는 검사법이다. 기능적인 정보를 담고 있는 심근관류 영상은 비침습적인 심근질환 검사에 유용한 방법이지만, 물리적 인자들에 의해 잡음과 낮은 해상도는 판도하는데 어려움을 주게 된다. 본 논문은 심근영상을 레벨 셋 알고리즘을 이용하여 영상을 분할하고 분할된 영역을 3차원으로 구현하여 판독에 도움을 주는 방안을 제안하였다. 판독의 어려움을 해결하기 위하여 레벨 셋을 이용하여 관심부위인 좌심실 영역을 분할하였고 분할된 영역을 3차원영상으로 모델링하였다.

• 한국산학기술학회논문지
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• 제11권6호
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• pp.2240-2245
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• 2010

심근영상의 SPECT(Single Photon Emission Computed tomography)검사는 감마선을 방출하는 방사성의약품을 환자에게 정맥주사한 후 이 의약품이 심장에 고루 퍼지면 관심부위를 촬영하여 질병으로 인한 변화를 컴퓨터를 이용하여 진단하는 검사법이다. 기능적인 정보를 담고 있는 심근관류 영상은 비침습적인 심근질환 검사에 유용한 방법이지만, 물리적 인자들에 의해 잡음과 낮은 해상도는 판도하는데 어려움을 주게 된다. 본 논문은 심근영상을 레벨 셋 알고리즘을 이용하여 영상을 분할하고 분할된 영역을 3차원으로 구현하여 판독에 도움을 주는 방안을 제안하였다. 판독의 어려움을 해결하기 위하여 레벨 셋을 이용하여 관심부위인 좌심실 영역을 분할하였고 분할된 영역을 3차원영상으로 모델링 하였다.

• 한국임상수의학회지
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• 제25권1호
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• pp.48-51
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• 2008

심한 복부팽만과 호흡 곤란 증세를 보이는 10살의 요크셔 테리어가 내원하였다. 방사선과 초음파 검사로 우심방과 주폐동맥에 인접한 대동맥 주위로 고에코성의 큰 종괴를 확인하였다. 확인된 종양은 심장 기저부 주위에 존재하는 확장성 종양으로 삼첨판 역류, 대량의 복수와 간정맥 확장을 동반한 간종대와 같은 우심 부전 소견을 보였다. 전산화단층촬영법으로 확인된 이 종괴는 전대정맥에서 후대정맥까지 위치한 심장 기저부 주위에 존재하는 크고 비균질성을 띤 종괴였다. 이 종괴는 전대정맥, 심장, 후대정맥 및 흉벽까지 침습되어 있었으며, 세침흡입술을 통한 잠정적인 진단은 Chemodectoma였다. 본 증례로 다양한 진단 영상학적 수단을 통한 심기저부 종양에 대한 특징 및 역할을 알 수 있었다.

• Journal of Korean Neurosurgical Society
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• 제44권2호
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• pp.98-100
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• 2008

We report a very rare case of a rapidly calcified chronic epidural hematoma (EDH) in a neonate. A 26-day-old female infant was referred to us from a regional hospital because of drowsy mentality and a seizure attack. She was delivered through caesarian section because normal spontaneous vaginal delivery was prolonged and failed. At birth, mild scalp swelling was found on the right frontal area. Scalp swelling was spontaneously resolved and she was discharged without any problems. On the 25th day after her birth, the baby presented with drowsiness and hypotonia following a generalized tonic-clonic seizure. Magnetic resonance imaging (MRI) and a computed tomography (CT) scan revealed a chronic EDH that had a thick layer of calcification. A small burr-hole trephination was performed and a single silastic drainage catheter was inserted. After the operation, a total of 12 ml of liquefied hematoma was drained, and the patient's mentality improved from drowsiness to alertness. The patient was asymptomatic when discharged.

• Journal of Korean Neurosurgical Society
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• 제54권6호
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• pp.518-520
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• 2013

Ossified lipoma or osteolipoma are rarely reported. It is defined as a histologic variant of lipoma that has undergone osseous metaplasia. Osteolipoma presents with a dominant osseous component within a lipoma. We report a case of a histologically confirmed osteolipoma on the nuchal ligament independent of bone. The patient was a 51-year-old female who presented with a 5-year history of a painless, progressively enlarging mass on the posterior neck. Computed tomography and magnetic resonance imaging showed a circumscribed mass compatible with fat between the C2 and C6 spinous processes with a large calcified irregular component. The mass with dual components was totally removed under general anesthesia and no recurrence was observed after 6 months of follow-up. We also reviewed the clinicopathologic features of previously reported osteolipomas in the literature and suggest that although osteolipoma is a rare variant of lipoma, it should be considered in the differential diagnosis when a lipoma of the posterior neck mixed with a bony component is encountered.

• Journal of Korean Neurosurgical Society
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• 제58권2호
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• pp.141-143
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• 2015

Among the distal anterior inferior cerebellar artery (AICA) aneurysms, a unique aneurysm at the meatal loop inside the internal auditory meatus is extremely rare. The authors report a case of surgically treated total intrameatal AICA aneurysm. A 62-year-old female patient presenting with sudden bursting headache and neck pain was transferred to our department. Computed tomography and digital subtraction angiography showed subarachnoid hemorrhage at the basal, prepontine cistern and an aneurysm of the distal anterior inferior cerebellar artery inside the internal auditory meatus. Surgery was performed by retrosigmoid craniotomy with unroofing of the internal auditory meatus. The aneurysm was identified between the seventh and eighth cranial nerve in the meatus and was removed from the canal and clipped with a small straight Sugita clip. After operation the patient experienced transient facial paresis and tinnitus but improved during follow up.

• Journal of Korean Neurosurgical Society
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• 제44권3호
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• pp.170-173
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• 2008

Ventriculoperitoneal (VP) shunt is commonly and effectively used to treat hydrocephalus. Intracardiac migration of the shunt catheter is a rare complication. A 68-year-old woman underwent ventriculoperitoneal shunting for hydrocephalus secondary to subarachnoid hemorrhage due to anterior communicating artery aneurysm rupture. Two weeks after the shunt surgery, she had suffered from the abdominal pain. Plain chest x-rays, computed tomography, and echocardiography revealed the distal catheter which was in the right ventricle of the heart. We tried to remove the catheter through the internal jugular vein by fluoroscopic guidance. But, the distal catheter was kinked and knotted; therefore, we failed to withdraw the catheter. After then, we punctured the right femoral vein and pulled down the multi-knotted shunt catheter to the femoral vein using the snare catheter. Finally, we removed the knotted distal catheter via the femoral vein and a new distal catheter was placed into the peritoneal cavity. We report a case in which the distal catheter of the VP shunt migrated into the heart via the internal jugular vein. We emphasize the importance of careful and proper placement of the distal catheter during the tunneling procedure to prevent life-threatening complications.

• Journal of Korean Neurosurgical Society
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• 제56권1호
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• pp.55-57
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• 2014

Synovial cysts of the cervical spine, although they occur infrequently, may cause acute radiculopathy or myelopathy. Here, we report a case of a cervical synovial cyst presenting as acute myelopathy after manual stretching. A 68-year-old man presented with gait disturbance, decreased touch senses, and increased sensitivity to pain below T12 level. These symptoms developed after manual stretching 3 days prior. Computed tomography scanning and magnetic resonance imaging revealed a 1-cm, small multilocular cystic lesion in the spinal canal with cord compression at the C7-T1 level. We performed a left partial laminectomy of C7 and T1 using a posterior approach and completely removed the cystic mass. Histological examination of the resected mass revealed fibrous tissue fragments with amorphous materials and granulation tissue compatible with a synovial cyst. The patient's symptoms resolved after surgery. We describe a case of acute myelopathy caused by a cervical synovial cyst that was treated by surgical excision. Although cervical synovial cysts are often associated with degenerative facet joints, clinicians should be aware of the possibility that these cysts can cause acute neurologic symptoms.

• Clinics in Shoulder and Elbow
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• 제19권3호
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• pp.143-148
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• 2016

Background: The purpose of our study was to evaluate the accuracy of reduction based on postoperative computed tomography (CT) images after arthroscopic stabilization using tightrope system for unstable distal clavicle fracture. Methods: Twelve patients with distal clavicle fracture combined with coracoclavicular (CC) ligament injury (type II, V) who received arthroscopically assisted fixation using a flip button device were evaluated for accuracy of reduction using 3-dimensional postoperative CT scan by measuring the degree of distal clavicular angulation and clavicular shortening. Results: Immediate postoperative plain radiograph confirmed restoration of the CC distance (CCD) in 10 patients. At final follow-up, the CCD remained reduced anatomically on plain radiographs in these patients. All patients showed excessive posterior angulation and shortening compared to the opposite side. The average Constant score recovered to 94.8 at final follow-up. Conclusions: Indirect reduction and arthroscopic subacromial approach with flip button fixation of unstable distal clavicle fractures demonstrated favorable clinical results despite unavoidable posterior angulation of distal clavicle and shortening the total length of clavicle.