• Tuberculosis and Respiratory Diseases
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• v.70 no.3
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• pp.257-260
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• 2011

A 65-year-old woman was admitted due to poor oral intake and a dry cough over the previous 3 months. The physical examination was remarkable for bibasilar crackles, and plain chest radiography showed reticulation in both lower lung fields. A pulmonary function test demonstrated a restrictive pattern with a reduced diffusing capacity of the lung for carbon monoxide. High resolution computed tomography showed reticulation and honey-combing in both peripheral lung zones, which was consistent with usual interstitial pneumonia pattern. Her skin showed livedo reticularis. The erythrocyte sedimentation rate and C-reactive protein level were elevated, and hematuria was noted on urinary analysis. A serologic test for auto-antibodies showed seropositivity for Myeloperoxidase-Anti-neutrophil cytoplasmic antibody (MPO-ANCA). A kidney biopsy was performed and showed focal segmental glomerulosclerosis. She was diagnosed as having pulmonary fibrosis with microscopic polyangiitis (MPA) and treated with high dose steroids. Here we report a case of pulmonary fibrosis coexistent with microscopic polyangiitis.

• Clinics in Shoulder and Elbow
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• v.18 no.3
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• pp.152-158
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• 2015

Background: Acromioclavicular (AC) stability is maintained through a complex combination of soft-tissue restraints that include coracoclavicular (CC), AC ligament and overlying muscles. Among these structures, the role of the CC ligament has continued to be studied because of its importance on shoulder kinematics, especially after AC injury. This study was designed to determine the geometric change of conoid and trapezoid ligaments and resulting stresses on these ligaments according to various scapular motions. Methods: The scapuloclavicular (SC) complex was isolated from a fresh-frozen cadaver by removing all soft tissues except the AC and CC ligaments. The anatomically aligned SC complex was then scanned with a high-resolution computed tomography scanner into 0.6- mm slices. The Finite element model of the SC complex was obtained and used for calculating the stress on different parts of the CC ligaments with simulated movements of the scapula. Results: Average stress on the conoid ligament during anterior tilt, internal rotation, and scapular protraction was higher, whereas the stress on the trapezoid ligament was more prominent during posterior tilt, external rotation, and retraction. Conclusions: We conclude that CC ligament plays an integral role in regulating horizontal SC motion as well as complex motions indicated by increased stress over the ligament with an incremental scapular position change. The conoid ligament is the key structure restraining scapular protraction that might occur in high-grade AC dislocation. Hence in CC ligament reconstructions involving only single bundle, every attempt must be made to reconstruct conoid part of CC ligament as anatomically as possible.

• KIPS Transactions on Software and Data Engineering
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• v.1 no.2
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• pp.109-114
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• 2012

Honeycombs are dense structures that small cysts, which generally have about 2~10 mm in diameter, are surrounded by the wall of fibrosis. When honeycomb is found in the patients, the incidence of acute exacerbation is generally very high. Thus, the observation and quantitative measurement of honeycomb are considered as a significant marker for clinical diagnosis. In this point of view, we propose an automatic segmentation method using morphological image processing and assessment of the degree of clustering techniques. Firstly, image noises were removed by the Gaussian filtering and then a morphological dilation method was applied to segment lung regions. Secondly, honeycomb cyst candidates were detected through the 8-neighborhood pixel exploration, and then non-cyst regions were removed using the region growing method and wall pattern testing. Lastly, final honeycomb regions were segmented through the extraction of dense regions which are consisted of two or more cysts using cluster analysis. The proposed method applied to 80 High resolution computed tomography (HRCT) images and achieved a sensitivity of 89.4% and PPV (Positive Predictive Value) of 72.2%.

• Imaging Science in Dentistry
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• v.36 no.1
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• pp.49-54
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• 2006

Purpose : To evaluate accuracy and reliability of program to measure facial soft tissue thickness using 3D computed tomographic images by comparing with direct measurement. Materials and Methods : One cadaver was scanned with a Helical CT with 3 mm slice thickness and 3 mm/sec table speed. The acquired data was reconstructed with 1.5 mm reconstruction interval and the images were transferred to a personal computer. The facial soft tissue thickness were measured using a program developed newly in 3D image. For direct measurement, the cadaver was cut with a bone cutter and then a ruler was placed above the cut side. The procedure was followed by taking pictures of the facial soft tissues with a high-resolution digital camera. Then the measurements were done in the photographic images and repeated for ten times. A repeated measure analysis of variance was adopted to compare and analyze the measurements resulting from the two different methods. Comparison according to the areas was analyzed by Mann-Whitney test. Results : There were no statistically significant differences between the direct measurements and those using the 3D images (p>0.05). There were statistical differences in the measurements on 17 points but all the points except 2 points showed a mean difference of 0.5 mm or less. Conclusion : The developed software program to measure the facial soft tissue thickness using 3D images was so accurate that it allows to measure facial soft tissues thickness more easily in forensic science and anthropology.

• Journal of Cardiovascular Imaging
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• v.31 no.1
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• pp.18-23
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• 2023

BACKGROUND: Three-dimensional (3D) transesophageal echocardiogram (TEE) is the gold standard for the diagnosis of degenerative mitral regurgitation (dMR) and preoperative planning for transcatheter mitral valve repair (TMVr). TEE is an invasive modality requiring anesthesia and esophageal intubation. The severe acute respiratory syndrome coronavirus 2 pandemic has limited the number of elective invasive procedures. Multi-detector computed tomographic angiography (MDCT) provides high-resolution images and 3D reconstructions to assess complex mitral anatomy. We hypothesized that MDCT would reveal similar information to TEE relevant to TMVr, thus deferring the need for a preoperative TEE in certain situations like during a pandemic. METHODS: We retrospectively analyzed data on patients who underwent or were evaluated for TMVr for dMR with preoperative MDCT and TEE between 2017 and 2019. Two TEE and 2 MDCT readers, blinded to patient outcome, analyzed: leaflet pathology (flail, degenerative, mixed), leaflet location, mitral valve area (MVA), flail width/gap, anterior-posterior (AP) and commissural diameters, posterior leaflet length, leaflet thickness, presence of mitral valve cleft and degree of mitral annular calcification (MAC). RESULTS: A total of 22 (out of 87) patients had preoperative MDCT. MDCT correctly identified the leaflet pathology in 77% (17/22), flail leaflet in 91% (10/11), MAC degree in 91% (10/11) and the dysfunctional leaflet location in 95% (21/22) of patients. There were no differences in the measurements for MVA, flail width, commissural or AP diameter, posterior leaflet length, and leaflet thickness. MDCT overestimated the measurements of flail gap. CONCLUSIONS: For preoperative TMVr planning, MDCT provided similar measurements to TEE in our study.

• Journal of Chest Surgery
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• v.32 no.8
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• pp.693-701
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• 1999

Recently non-invasive diagnostic imaging replaced the invasive catheter angiography in the diagnosis of vascular disease. Catheter methods are now almost confined to the purpose of intervention. Coronary artery or coronary artery bypass graft still needs catheter technique because of small diameter and the cardiac motion. The last challenge for radiologists in this domain is to obtain a non-invasive imaging. Electron beam tomography(EBT) for high temporal resolution is able to obtain a coronary arteriogram or coronary artery bypass graft (CABG), of which CABG imaging is quite useful for the evaluation of patency. In our experience as well as others, the accuracy of EBT angiogram in evaluating CABG patency revealed that the accuracy of patency of saphenous vein grafts(SVG) is high due to relatively wide lumen, short and straight course and less influence from cardiac motion. The sensitivity and specificity of patency of SVGs were 92%, 97% respectively in the prospective evaluat on and 100% each in the retrospective evaluation. A false positive and a false negative case are rudimentary errors in the initial learing period. In contrast the analysis of left internal mammary artery(LIMA) graft was difficult due to the inherent small size and the adjacent surgical clips provoking beam-hardening artifact; therefore, the method of combining 3 dimensional reconstruction and flow mode study was important in improving the accuracy of LIMA patency. The sensitivity and specificity of LIMA patency were 100% and 80% in both prospective and retrospective evaluation. Therefore, EBT angiography is an accurate non-invasive diagnostic modality for evaluating the patency of CABG, particularly in SVGs. The accuracy can be improved with the improvement of the EBT and the development of the image reconstruction software.

• Pediatric Infection and Vaccine
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• v.14 no.1
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• pp.124-128
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• 2007

Bronchiolitis obliterans is a clinical syndrome of chronic obstruction associated with inflammatory changes in the small airways. There are marked variations in the epidemiology of this disease. In childhood, bronchiolitis obliterans has been described as a result of a number of infections such as adenovirus, measles, Bordetella pertussis, Mycoplasma pneumoniae, and influenza A infection. Most common agents are adenovirus types 3, 7, and 21. Diagnosis of bronchiolitis obliterans can be made based on clinical findings, high resolution computed tomography (HRCT) and lung biopsy. In addition to diagnosis, treatment is not yet clearly established. The authors experienced a case of bronchiolitis obliterans developed in 3 year-old girl who suffered from type 7 adenoviral pneumonia. She had been hospitalized and treated for 15 days due to pneumonia. After discharge, productive cough was not improved and auscultation revealed wheezing. HRCT demonstrated multifocal mosaic patterns suggesting bronchiolitis obliterans. She was managed with inhaled steroid and bronchodilator, and her symptoms were improved. However, follow up HRCT showed no interval change.

• Tuberculosis and Respiratory Diseases
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• v.67 no.6
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• pp.569-573
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• 2009

Idiopathic pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by surfactant component accumulation in the alveolar space. Idiopathic PAP has recently been recognized as a autoimmune disease of impaired alveolar macrophage function caused by autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF). While whole lung lavage has been the standard treatment, not every patient shows a complete response. Subcutaneous injection or inhalation of GM-CSF is another promising treatment option for PAP. A 45-year-old patient visited our hospital for dyspnea, he was diagnosed as PAP and underwent whole lung lavage. Eighteen months later, the patient had not achieved complete remission in despite of initial response. After then he was administered with GM-CSF (5 ${mu}g/kg/day$, subcutaneous injection) for fivetimes a week during 2 months. Nine months later, the abnormal shadows in high-resolution computed tomography (HRCT) decreased and the patient fully recovered in forced vital capacity. After 60 months, the HRCT scan showed complete remission of PAP.

• Clinical and Experimental Pediatrics
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• v.45 no.4
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• pp.529-534
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• 2002

Interstitial pneumonia is a heterogenous group of inflammatory and fibrosing lesions that manifest themselves as infiltrative lung disease. Of these, nonspecific interstitial pneumonia is characterized as a variable degree of interstitial inflammation with or without fibrosis and is distinguished from usual interstitial pneumonia and desquamative interstitial pneumonia, histologically. The influx of inflammatory cells and the responses of immune effector cells injury to the alveolar wall and these initial injuries results in alveolitis and fibrosis. Consequently, the gas exchange throughout the alveolar wall is impaired and the patients suffer from lung diseases of a restrictive pattern. The chief complaints represented are dyspnea and dry cough. We experienced a case of nonspecific interstitial pneumonia in a 10-year old girl. The patient had been healthy and had not been exposed to organic dusts or other toxic materials. The pathology of lung biopsy tissue showed that the alveoli were thickened by a mixture of chronic inflammatory cells and collagen type fibrosis. High resolution computed tomography(HRCT) found the patchy areas of ground-glass opacity with patchy consolidation and irregular reticular opacity, and diffuse distribution without zonal predominance. The forced vital capicity(FVC) was 31%, forced expiratory volume in one second ($FEV_1$) 29% and $FEV_1/FVC$ 90%, so a restrictive pulmonary insufficiency was found.

• Journal of radiological science and technology
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• v.30 no.3
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• pp.281-287
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• 2007

Contrast media may cause tissue injury by extravasation during intravenous automated injection during CT examination. Here, we present a study in which contrast media extravasation was detected and localized in the neck and thorax by three-dimensional(3D) CT data reformation. The CT studies of the extavasation site were performed using a 3D software program with four different display techniques axial, multi planar reformation(MPR), maximum intensity projection(MIP), and volume rendering displays are currently available for reconstructing MDCT data. 3D image reconstructions provide accurate views of high-resolution imaging. This paper introduces extravasation with the MDCT and 3D reformation findings of contrast media extravasation in neck ant thorax. The followed injection of the external jugular vein into an existing intravenous catheter and a large volume of extravasation was demonstrated on by 3D MDCT.