• Journal of Gastric Cancer
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• v.14 no.2
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• pp.142-146
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• 2014

Pulmonary tumor thrombotic microangiopathy (PTTM) causing fatal pulmonary hypertension is a rare presentation of malignancy. In general, patients with PTTM rapidly succumb to death due to severe hypoxia. To date, very few cases of PTTM have been reported in the literature; and most of these cases were from gastric cancer and were diagnosed on post mortem autopsy, as it is extremely challenging to make an ante mortem diagnosis. We here report on a case of undiagnosed diffuse gastric cancer, presenting as worsening hypoxia. The clinical, radiographic, and echocardiographic features, and laboratory and pathological results were consistent with PTTM from gastric cancer. The patient was started on anticoagulation therapy, corticosteroids, and high-flow oxygen. However, her hypoxia worsened to the extent that she required ventilator support, and she died soon after intubation due to cardiac arrest. Since diffuse gastric cancer is associated with hereditary diffuse gastric cancer syndrome, cadherin 1 gene mutation analysis was performed to estimate the risk to her daughters. The test came back negative.

• Journal of Korean Dental Science
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• v.4 no.1
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• pp.20-25
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• 2011

Purpose: To describe the newly developed Film image transfer system (FITS) for proper positioning of the orthodontic mini-implant in the narrow interdental space and considerations for better application. Materials and Methods: A patient who was planning to have orthodontic mini-implant treatment on the posterior maxilla was recruited to assess the feasibility of FITS. Dental radiographic film and bite record was taken. And then the film image was transferred on the photographic emulsion coated model using transfer light through film projector (enlarger). After exposing the photo emulsion coating on the model, the image was developed with a working solution for a paper developer and fixed. The surgical guide for the mini-implant was fabricated from the transported FITS data. Results: The completed surgical guide was easily placed intraorally, and allowed a simple and rapid placement of the mini-implant. The site of the implant placement was accurate as planned position. Conclusion: In the reported case, The FITS technique represents an effort to minimize risk to the patient and produce consistently good results based upon accurate information about the anatomy of the implant site.

• Imaging Science in Dentistry
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• v.50 no.1
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• pp.31-36
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• 2020

Purpose: The purpose of this study was to investigate the impact of radiotherapy on mandibular bone tissue in head and neck cancer patients through an analysis of pixel intensity and fractal dimension values on digital panoramic radiographs. Materials and Methods: Thirty patients with radiographic records from before and after 3-dimensional (3D) conformational radiotherapy were selected. A single examiner carried out digital analyses of pixel intensity values and fractal dimensions, with the areas of interest unilaterally located in the right angle medullary region of the mandible below the mandibular canal and posterior to the molar region. Results: Statistically significant decreases were observed in the mean pixel intensity (P=0.0368) and fractal dimension (P=0.0495) values after radiotherapy. Conclusion: The results suggest that 3D conformational radiotherapy for head and neck cancer negatively affected the trabecular microarchitecture and mandibular bone mass.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.18 no.1
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• pp.67-73
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• 1988

This study was performed to clarify the mechanism of clicking sound and locking on temporomandibular joint and to determine the radiographic findings of them by using computed tomogram. Through the preliminary study with cadavers, the proper scanning condition and the correlatonship between the anatomy of cadaver and computed tomogram had been determined. The subjects were consisted of 10 controls and 16 patients having clicking sound or locking on temporomandibular joint. By using Hitachi-W500 as computed tomographic device, direct axial views and sagittal views reformed according to the changes in window setting and using the non-linear fraction were taken and analyzed by visual method and measuring the attenuation numbers. The obtained results were as follows: 1. The density of the anterior band of meniscus showed isodense to the surrounding muscles in normal. 2. In patient group, affected side showed increased radiopaque area anterior to condyle and underneath articular eminence as the feature of anteriorly displaced meniscus on axial and sagittal views. 3. In patient group, the condyle was rotated postero-laterally in affected side. 4. Non-linear fraction highlightened the feature of anteriorly displaced meniscus.

• Imaging Science in Dentistry
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• v.48 no.1
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• pp.67-72
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• 2018

Historically, Eagle syndrome is a term that has been used to describe radiating pain in the orofacial region, foreign body sensation, and/or dysphagia due to a unilateral or bilateral elongated styloid process impinging upon the tonsillar region. Because elongated styloid processes-with or without associated Eagle syndrome-can present with various symptoms and radiographic findings, it can be challenging for healthcare practitioners to formulate an accurate diagnosis. Abnormal styloid anatomy can lead to a multitude of symptoms, including chronic orofacial/neck pain, thus masquerading as more commonly diagnosed conditions. In this report, we describe a patient who presented to our department with styloid process elongation and fracture. A careful history, physical examination, and a cone-beam computed tomography (CBCT) investigation led to the diagnosis. The patient was then referred for appropriate care. This case report demonstrates the utilization of CBCT in differentiating a fracture site from a pseudo-joint that might mimic a fracture.

• Tuberculosis and Respiratory Diseases
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• v.70 no.1
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• pp.10-20
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• 2011

Various diseases can diffusely involve central airways, including the trachea and main stem bronchi. Central airway abnormalities are frequently not apparent or are overlooked on chest radiographs, even though the patient may have significant symptoms. Recent advances in spiral and multi-detector computed tomography (CT) with multi-planar reconstruction and three-dimensional demonstration, including virtual bronchoscopy, allow for excellent display of central airway anatomy and abnormalities with visualization of accurate locations of lesions. Early detection and proper diagnosis of airway diseases based on various radiographic findings will help determine appropriate treatment, including surgical planning and evaluation of treatment response. Herein we describe and illustrate the imaging findings of a wide spectra of diffuse central airway diseases.

• Imaging Science in Dentistry
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• v.52 no.1
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• pp.27-32
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• 2022

Purpose: The aim of this study was to compare mastoid air cell volumes in patients with or without a pneumatized articular tubercle (PAT) on cone-beam computed tomography (CBCT) images. Materials and Methods: The CBCT images of 224 patients were retrospectively analyzed for the presence of PAT. The Digital Imaging and Communications in Medicine data of 30 patients with PAT and 30 individuals without PAT were transferred to 3D Doctor Software. Mastoid air cell volumes were measured using semi-automatic segmentation on axial sections. Data were analyzed using SPSS version 20.0. Results: The patients with PAT and those without PAT had a mean mastoid volume of 6.31±2.86 cm³ and 3.25±1.99 cm³, respectively. There were statistically significant differences in mastoid air cell volumes between patients with and without PAT regardless of sex and mastoid air cell side (P<0.05). Conclusion: The detection of PAT on routine dental radiographic examinations might be a potential prognostic factor that could be used to detect extensive pneumatization in the temporal bone. Clinicians should be aware that there may be widespread pneumatization of mastoid air cells in patients in whom PAT is detected. Advanced imaging should be performed in these cases, and possible complications due to surgical interventions should be considered.

• Imaging Science in Dentistry
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• v.53 no.4
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• pp.283-289
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• 2023

The apnea-hypopnea index is widely regarded as a measure of the severity of obstructive sleep apnea (OSA), a condition characterized by recurrent episodes of apnea or hypopnea during sleep that induce airway collapse. OSA is a catastrophic problem due to the wide range of health issues it can cause, including cardiovascular disease and memory loss. This review was conducted to clarify the roles of various imaging modalities, particularly cone-beam computed tomography (CBCT), in the diagnosis of and preoperative planning for OSA. Unfortunately, 2-dimensional imaging techniques yield insufficient data for a comprehensive diagnosis, given the complex anatomy of the airway. Three-dimensional (3D) imaging is favored as it more accurately represents the patient's airway structure. Although computed tomography and magnetic resonance imaging can depict the actual 3D airway architecture, their use is limited by factors such as high radiation dose and noise associated with the scans. This review indicates that CBCT is a low-radiation imaging technique that can be used to incidentally identify patients with OSA, thereby facilitating early referral and ultimately enhancing the accuracy of surgical outcome predictions.

• Restorative Dentistry and Endodontics
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• v.27 no.4
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• pp.421-431
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• 2002

C-shaped canal configuration is very difficult to treat because that clues about preoperative canal anatomy cannot be ascertained from clinical crown morphology and limited information can be derived from radiographic examination. This study was done to get more informations about the root and canal configuration of C-shape root by 3-dimensionally reconstructing for the purpose of enhancing success rate of endodontic treatment. 30 mandibular molars with C-shaped root were selected. Six photo images from occlusal, apical, mesial, distal, buccal, lingual directions and radiographic view were taken as preoperative ones to compare them with 3-D image. After crown reduction to the level of 1-2mm over pulpal floor was performed, teeth were stored in 5.25% sodium hypochlorite solution for the removal of pulp tissue and debris. They were cleaned under running water, allowed to bench dry and embedded in a self-curing resin. This resin block was serially ground with a microtome (Accutom-50, Struers, Denmark) and the image of each level was recorded by digital camera (FinePix S1-pro, Fuji Co., Japan). The thickness of each section was 0.25mm. Photographs of serial sections through all root canal were digitized using Adobe Photoshop 5.0 and then minimum thickness of open and closed sites were measured (open site is the surface containing occluso-apical groove closed site is oppsite). After dizitization using 3-D Doctor (Able software Corp, USA). 3D reconstruction of the outer surface of tooth and the inner surface of pulp space was made. Canal classsification of C-shaped roots was performed from this 3-D reconstructed image. The results were as follows : 1. Most C-shape rooted teeth showed lingual groove (28/30). 2 According to Vertuccis' calssification, type I, II, III, IV, VII were observed. but also new canal types suck as 2-3-2, 1-2-3-2. 2-3-2-1, 2-3-2-3 were shown. 3 There was little difference in minimum thickness on coronal and apical portions, but open site were thinner than closed site on mid portion. Conclusively, 3D reconstruction method could make the exact configurations of C-shape root possible to be visualized and analyzed from multi-directions. Data from minimum thickness recommend cleaning and shaping be more carefully done on dangerous mid portion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.636-643
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• 2000

Facial asymmetry is the most frequent disease in craniofacial deformities. And the primary causing area of that is mostly placing in mandible. That is to say, it is known that primarily, mandible grows excessively or deficiently, and other facial region involving maxilla undergoes compensatory growth secondarily, so asymmetric face develops. In facial asymmetry, the surgical correction of undergrowth is more difficult than that of overgrowth and the reason of it is the postoperative relapse caused by stress of surrounding soft tissues. It means the stress of surrounding soft tissues occurring after bone lengthening and reducing above stress is the same meaning with reducing postoperative relapse. Among various areas, mandibular ramus is the most difficult area to lengthen vertically and maintain its length. The reason of it is considered by many authors as the stress of surrounding pterygomasseteric sling which is enveloping lower border of mandible and interrupting elongation of ramal height. So we applied two different surgical procedures in which pterygomasseteric slings have different stress respectively to monkeys which have similar masticatory function and anatomy to human being and compared relapse by radiographic film and observed periodically the histochemical change of masseteric muscle fiber. So we could see the following results. The relapse was less in EVRO group in which we separated pterygomasseric sling in inferior border and didn't approximate muscle sling after vertical lengthening to minimize the stress of soft tissues than IVRO group in which we elongated ramal height preserving pterygomassetric sling. Of course, we could see a problem in EVRO group such as bone resorption in inferior border caused by uncovering the periosteum of inferior border. But we expect that such problem will be solved by developing periosteum substitutes for covering the exposed bone and minimizing the surgical trauma. In histochemical study of masseteric muscle fiber, the fiber constituents of EVRO group in which we minimized soft tissue stress was changed immediately after operation and maintained it for 1 year, whereas that of IVRO group in which we preserved soft tissue stress was changed in more portion after operation and recovered it by 1 year. By the histochemical results, we can see that the recovery of fiber constituents reflect the recovery of muscle stress and it is closely related with relapse phenomenon.