• Journal of Korean Neurosurgical Society
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• 제59권4호
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• pp.368-373
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• 2016

Objective : Delayed hinge fracture (HF) that develops after cervical open door laminoplasty can be a source of postoperative complications such as axial pain. However, risk factors related to this complication remain unclear. We performed a retrospective clinical series to determine risk factors for delayed HF following plate-only open-door cervical laminoplasty. Methods : Patients who underwent plate-only open-door laminoplasty and had available postoperative computed tomography (CT) scans (80 patients with 270 laminae) were enrolled. Hinge status, hinge gutter location, open location, hinge width, number of screws used, operation level, and open angle were observed in the CT to determine radiographic outcome. Demographic data were collected as well. Radiographic and clinical parameters were analyzed using univariate and multivariate logistic regression analysis to determine the risk factors for HF. Results : Univariate logistic regression analysis results indicated poor initial hinge status, medially placed hinge gutter, double screw fixation on the elevated lamina, upper surgical level, and wide open angle as predictors for HF (p<0.05). Initial hinge status seemed to be the most powerful risk factor for HF (p=0.000) and thus was collinear with other variables. Therefore, multivariate logistic regression analysis was performed excluding initial hinge status, and the results indicated that medially placed hinge gutter, double screw fixation on the elevated lamina, and upper surgical level were risk factors for HF after adjustment for other confounding factors. Conclusion : To prevent HF and to draw a successful postoperative outcome after cervical laminoplasty, surgical and clinical precautions should be considered.

• 대한의용생체공학회:의공학회지
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• 제39권1호
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• pp.1-9
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• 2018

This study was carried out to evaluate the effect of micro-current therapy on muscle atrophy and delayed wound healing process caused by traumatic peripheral nerve injury. For this, twenty-five 5-week-old Sprague Dawley rat were used and assigned to five groups including the normal group (NOR, n=5), the wound group (WD, n=5), the wounded and treated with micro-current electrical therapy group (WD+MET, n=5), the sciatic nerve denervated and wounded group (WD+DN, n=5), and the sciatic nerve denervated, wounded and treated with micro-current electrical therapy group (WD+DN+MET, n=5). In order to assess the changes in length of incisional wound for 12 days and the muscle volume for 2 weeks, the ImageJ analysis of macroscopic analysis and micro-CT data were obtained and analyzed. As a result, significant delay in the process in wound healing were observed and micro-current therapy suppress the postponement of healing process. Furthermore, there were significant changes in muscle volume between electrically treated group and non-treated group. These result shows that electrical stimulation may improve the delayed healing process and muscle atrophy at once.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.233-237
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• 2013

Delayed traumatic intracerebral hemorrhage (DT-ICH) is a rare event in head trauma patients. However, it develops unexpectedly and results in very severe brain damage. Thus, close monitoring of the neurologic status is needed for every trauma patient. Sometimes, however, neurologic monitoring cannot be done because of sedation, especially in cases of abdominal surgery. In this case report, we describe the case of a 37-yr-old, male patients who had hemoperitoneum because of spleen and renal injury. At the initial operation, massive bleeding was found, so gauze-packing surgery was done first. After the first operation, we sedated the patient for about two days, after which the packed gauze was removed, and the abdominal wound was closed. Immediately after the second operation, we found pupil dilation. Emergent CT was performed. The CT revealed DT-ICH with severe brain edema and midline shifting. However, the patient condition deteriorated progressively despite emergency operation, he expired 2 days after hematoma evacuation.

• 대한방사선기술학회지:방사선기술과학
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• 제36권4호
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• pp.313-318
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• 2013

핵의학과에서 $^{18}F$-FDG PET/CT 검사는 종양의 진단 뿐 아니라 치료병기를 설정하는데 중요한 역할을 하고 있다. 하지만 정상 조직이나 양성 종양 간의 FDG 섭취를 초래하는 다양한 요인이 있어 정확한 진단에 혼란을 초래할 수 있다. 본 연구의 목적은 유방암환자에서 $^{18}F$-FDG PET/CT 지연 검사가 악성 종양과 양성 종양을 구별 하는데 있어 유용성을 가지고 있는지에 관하여 알아보고자 함에 있다. 본원을 내원하여 $^{18}F$-FDG PET/CT 검사를 받은 환자 중 방사선 치료나 화학 치료를 받은 환자를 제외한 액와림프절에 FDG섭취를 보인 27명의 환자를 대상으로 하였으며, $^{18}F$-FDG 투여 후 50분 후에 검사를 시행하였고 90분 후에 지연상을 획득했다. 종양의 병기 설정은 방사선 검사나 병리학적 검사를 바탕으로 확정된 결과를 바탕으로 분류 하였으며, 액와 림프절의 SUV는 Siemens사의 Syngo Aquisition Workplace로 측정하였다. 27명의 환자는 18명의 악성종양 군과 9명의 양성종양 군으로 분류하였고 악성종양 군은 액와림프절의 개수에 따라 1-3개는 N1, 4-9개는 N2, 10개 이상은 N3로 분류 하였다. 실험 결과는 평균${\pm}$표준편차로 표현하였고, SPSS (V.18 Inc., USA)를 사용하여 통계분석을 실행하였다. 50분 검사와 90분 검사 간의 비교 시, 악성종양 군의 RI-SUVmax는 양성종양 군에 비해 5배 이상의 증가를 보였다. N그룹에서의 RI-SUVmax는 N1에서 N3로 갈수록 점점 감소되는 경향을 보였지만 통계적 유의성을 확인 할 수 없었다. 그럼에도 불구하고 유방암 환자에서 RI-SUVmax는 액와림프절의 악성과 양성을 판단하는 좋은 지표가 되었고 이를 구별하는데 유용할 것으로 사료된다.

• Journal of Korean Neurosurgical Society
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• 제30권12호
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• pp.1375-1380
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• 2001

Objective : The authors analyzed the incidence, the cause and the prognosis of hydrocephalus following aneurysmal subarachnoid hemorrhage to evaluate the risk factors of hydrocephalus and to provide the proper treatment method for hydrocephalus following aneurysmal subarachnoid hemorrhage. Methods : The 505 cases of subarachnoid hemorrhage followed by aneurysmal surgery from January 1990 to May 1999, were divided into shunt group and shunt-free group and we were reviewed for the clinical status, Fisher's grade, brain CT findings and prognosis. Results : The incidence of acute hydrocephalus was 37.2% of patients and 18.9% to developed chronic hydrocephalus. Shunt surgery due to chronic hydrocephalus was required in 6.5% of patients. We found following variables were significantly related to shunt-dependent hydrocephalus : high Hunt-Hess and Fisher grade, initial CT findings of intraventricular hemorrahge, posterior circulation aneurysm, preoperative rebleeding, delayed ischemic deficits, and initial high ventricular size index. There were no statistically significant relationships between shunt-dependent hydrocephalus and patient age or sex, timing of operation. The previous hypertension was not related to shunt dependent hydrocephalus. Prognosis in shunt group showed poor result. Conclusion : The risk factors of hydrocephalus following aneurysmal subarachnoid hemorrhage are high Hunt-Hess grade, high Fisher's grade, aneurysms of posterior circulations, preoperative aneurysmal rebleeding, delayed ischemic deficits, initial CT findings of intraventricular hemorrahge and initially increased ventricular size. The patients with these factors should the carefully observed and managed accordingly due to poor prognosis related to hydrocephalus requiring shunt operation.

• Imaging Science in Dentistry
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• 제40권3호
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• pp.109-114
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• 2010

Purpose : This study was performed to analyze the position, pattern of impacted mesiodens, and their relationship to the adjacent teeth using Dental cone-beam CT. Materials and Methods : Sixty-two dental cone-beam CT images with 81 impacted mesiodenses were selected from about 2,298 cone-beam CT images at Chonnam National University Dental Hospital from June 2006 to March 2009. The position, pattern, shape of impacted mesiodenses and their complications were analyzed in cone-beam CT including 3D images. Results : The sex ratio (M : F) was 2.9 : 1. Most of the mesiodenses (87.7%) were located at palatal side to the incisors. 79% of the mesiodenses were conical in shape. 60.5% of the mesiodenses were inverted, 21% normal erupting direction, and 18.5% transverse direction. The complications due to the presence of mesiodenses were none in 43.5%, diastema in 19.4%, tooth displacement in 17.7%, delayed eruption or impaction in 12.9%, tooth rotation in 4.8%, and dentigerous cyst in 1.7%. Conclusions : Dental cone-beam CT images with 3D provided 3-dimensional perception of mesiodens to the neighboring teeth. This results would be helpful for management of the impacted mesiodens.

• 대한영상의학회지
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• 제83권2호
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• pp.400-405
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• 2022

위장관기질종양(gastrointestinal tumor; 이하 GIST)은 종종 위장관 출혈의 원인이 되는 드물지 않은 질환이지만 소장에 생기는 경우 내시경 및 전산화단층촬영(이하 CT)에서 발견이 어려울 수 있다. 본 증례에서 환자는 수술 전 총 3회의 CT를 시행 받았으나, 병변은 매번 복강의 다른 부위에 위치해 있었고, 허탈된 소장과 구분이 어려워 처음 2번의 CT에서는 발견하지 못했다. 혈관조영술에서 병변이 보였지만, 고령의 환자에서 원인불명 위장관 출혈의 가장 흔한 원인인 혈관기형으로 잘못 해석되어 올바른 진단과 치료가 3년간 지연되었다. 본 증례를 통해, GIST의 정확한 진단 및 치료 전략 수립을 위해 혈관조영술 소견을 강조하고자 한다.

• 대한핵의학회지
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• 제30권4호
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• pp.516-523
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• 1996

목 적 : 신경내분비종양 진단에 대한 I-123 MIBG 스캔의 4시간 조기 영상과 SPECT 영상의 임상적 유용성을 평가하고자 시행하였다. 대상과 방법 : CT 또는 MRI를 시행하여 신경내분비종양이 의심되었던 21예를 대상으로 I-123 MIBG 스캔을 시행하였으며 4시간에 전신 평면 영상과 SPECT 영상을 얻고, 17예에서는 12-24시간 사이에 지연 평면 영상도 얻었다. 결 과 : 21예중 12예에서 신경내분비종양으로 확진되었고, 4시간 I-123 MIBG 스캔의 진단적 예민도는 75%, 특이도는 89%였다. SPECT 영상은 CT나 MRI와의 비교 분석에 용이하였다. 지연 영상은 일부 진양성을 소견을 보인 예에서 종양 대 배후 방사능의 비가 증가하여 병변 확인에 도움이 되었으나 4시간 평면 영상과 진단율에 차이는 없었다. 결 론 : I-123 MIBG 스캔은 4시간 조기 영상으로도 신경내분비종양의 진단에 유용했으며, SPECT 영상은 다른 진단매체와의 비교 분석이 용이하였고 향후 종양의 종류에 따라 더 많은 예의 연구가 필요할 것으로 생각하였다.

• 대한후두음성언어의학회지
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• 제16권1호
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• pp.81-84
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• 2005

Vagus nerve palsy caused by herpes virus infection is rare. Here, the author presents a 65-year-old woman with acute onset of right side otalgia and sore throat, followed by delayed vocal fold paralysis on the same side. Vesicles were also found on the posterior wall of ear canal but the tympanic membrane was not involved. Laryngoscopy revealed multiple ulcerative lesions on the pharyngeal and laryngeal mucosa exclusively on the right side. One month later, she noticed dyshonia which turned out right vocal fold paralysis. Skull base to upper chest CT did not reveal local lesion. Three months after finishing the acyclovir, her symptoms were almost gone and vocal fold movement has almost completely improved. Vagus nerve involvement of herpes infection should be considered as a differential diagnosis for patients with herpes zoster oticus with sore throat.

• Journal of Yeungnam Medical Science
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• 제32권1호
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• pp.13-16
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• 2015

Portal vein gas and pneumatosis cystoides intestinalis are uncommon conditions and have been associated with poor prognosis. They are most commonly caused by necrotizing enterocolitis but may have other causes, and they can be associated with necrotizing and ischemic colitis, intra-abdominal abscess, small bowel obstruction, diverticulitis, colon cancer, and acute pancreatitis. With the more frequent use of computed tomography (CT) scans, portal vein gas and pneumatosis cystoides intestinalis have been increasingly detected in recent years. Because of its high mortality rate, necrotizing enteritis with portal vein gas and pneumatosis cystoides intestinalis may be treated with emergent exploratory laparotomy. We report a case of necrotizing enteritis with portal vein gas and pneumatosis cystoides intestinalis in a 47-year-old man treated with intensive medical management and delayed operation due to unstable condition and surgical mortality. He had good clinical results without complications after the delayed operation.