• Title/Summary/Keyword: delayed CT

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IATROGENIC IMPACTION OF LOWER LEFT PERMANENT CANINE : CASE REPORT (하악 영구 견치의 의원성 매복에 대한 증례 보고)

  • Kim, Song-Yi;Choi, Sung-Chul;Choi, Yeong-Chul;Park, Jae-Hong
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.339-344
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    • 2008
  • When a delayed eruption of tooth is diagnosed, the causative factor should be detected before an establishment of treatment plan, if possible. Although a panoramic radiograph is enough to evaluate the position of tooth and the stage of tooth development, a 3-D Dental CT would be a powerful tool to reveal a spatial relationships between objects. The reported case showed a delayed eruption of lower left permanent canine and a mini-plate with screws adjacent to the impacted canine. Although the screws adjacent to the root of impacted tooth showed a close proximity, it was not presumed that these screws would interfere the eruption of the tooth. The impacted canine did not show any spontaneous eruption during observation. After the mini-plate and screws were removed, an orthodontic traction using elastic power chain was performed. The position of mini-plates and screws should be carefully designed to avoid damaging the tooth follicles or tooth roots in the jaw. Also the screws should be removed before an orthodontic traction to prevent damaging the root surface of impacted tooth.

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Delayed Hemorrhage of the Hepatic Artery Caused by Biliary Stenting after Concurrent Chemoradiotherapy (동시항암화학방사선요법 후 담도 스텐트에 의해 발생한 지연성 간동맥 출혈)

  • Joon Ho Cho;Hyoung Nam Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1216-1221
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    • 2020
  • Neoadjuvant concurrent chemoradiotherapy has been increasingly used to obtain secondary resectability for locally advanced pancreatic cancers. Although most patients require biliary decompression, only a few studies have investigated the safety of biliary stenting with chemoradiotherapy. Herein, we report a rare case of delayed hemorrhage of the hepatic artery caused by biliary stenting after chemoradiotherapy. The serial follow-up CT demonstrated that the biliary stent was approaching the right hepatic artery and eventually caused acute angulation and indentation. Diagnostic catheter angiography revealed contrast extravasation at the right hepatic artery, and endovascular embolization was performed. This report highlights the relevance of anatomical deformation after chemoradiotherapy, which can result in fatal complications. Indentation of the hepatic artery caused by biliary stents should be recognized as a warning sign of vascular injury.

FDG Uptake and a Contrast Enhancement According to Histopathologic Types in Lung Cancers (폐암의 조직학적 분류에 따른 종양의 FDG 섭취와 CT 조영증강정도에 관한 연구)

  • Han, You-Mie;Choe, Jae-Gol;Kim, Young-Chul;Park, Eun-Kyung
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.1
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    • pp.19-25
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    • 2009
  • Purpose: The aims of this study were to analyze correlation between the maximum standardized uptake value (SUVmax) of 2-[F-18]-fluoro-2-deoxy-d-glucose (FDG) on positron emission computed tomography (PET-CT) scan and the degree of contrast enhancement on computed tomography (CT) scan in lung cancers, and to recognize the difference in SUVmax and CT enhancement between groups of different histopathologic subtypes. Materials and Methods: Our study included 53 patients of pathologically confirmed primary lung cancer, who were performed PET-CT and post-contrast chest CT. We calculated initial and delayed SUVmax (SUV1, SUV2), difference between SUV1 and SUV2 (SUVd), retention index (RI), and the degrees of CT contrast enhancement of lung cancers. We analyzed these variables for subtypes of lung cancers. Results: The values (mean$\pm$ standard deviation) were $8.3{\pm}4.4$ for SUV1, $10.7{\pm}5.7$ for SUV2, $2.4{\pm}1.6$ for SUVd, $30{\pm}14$ for RI and $47.1{\pm}14.8$ HU (Hounsfield Unit) for degree of CT contrast enhancement. The difference of SUV1 and degree of CT enhancement between subtypes was not meaningful. SUV1 showed positive correlations with SUVd (r=0.74, p<0,01) and tumor size (r=0.58, p<0.01), but no significant correlation with degree of CT enhancement (r=0.06, p=0.69). In 10 cases, there was discrepancy in the same mass between the area of highest FDG-uptake and the area of highest contrast enhancement. Conclusion: We suggest that FDG uptake in lung cancer does not have a positive linear correlation with degree of CT enhancement. And there is no significant difference in FDG uptake and degree of CT enhancement between different subtypes of lung cancers.

Closure of Petersen's Space Lowers the Incidence of Gastric Food Retention after Distal Gastrectomy with Gastrojejunostomy in Gastric Cancer Patients

  • Lee, Jaewon;Ahn, Hye Seong;Han, Dong-Seok
    • Journal of Gastric Cancer
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    • v.21 no.3
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    • pp.298-307
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    • 2021
  • Purpose: Delayed gastric emptying usually manifests as gastric food retention. This study aimed to evaluate the incidence of gastric food retention after distal gastrectomy with gastrojejunostomy in gastric cancer patients and identify the risk factors for its development. Materials and Methods: We retrospectively enrolled 245 patients who underwent distal gastrectomy with gastrojejunostomy for gastric cancer at Boramae Medical Center between March 2017 and December 2019. We analyzed the presence of gastric food residue via computed tomography (CT) scans at 3 and 12 months postoperatively and analyzed the risk factors that may influence the development of gastric food retention. Results: CT scans were performed on 235 patients at 3 months and on 217 patients at 12 months postoperatively. In the group that received closure of Petersen's space, the incidence of gastric food retention was significantly low as per the 3- and 12-month postoperative follow-up CT scans (P=0.028 and 0.003, respectively). In addition, hypertension was related to gastric food retention as per the 12-month postoperative follow-up CT scans (P=0.011). No other factors were related to the development of gastric food retention. In the multivariate analysis, non-closure of Petersen's space (hazard ratio [HR], 2.54; 95% confidence interval [CI], 1.20-5.38; P=0.010) was the only significant risk factor for gastric food retention at 3 months postoperatively, while non-closure of Petersen's space (HR, 2.81; 95% CI, 1.40-5.64; P=0.004) and hypertension (HR, 2.30; 95% CI, 1.14-4.63; P=0.020) were both significant risk factors for gastric food retention at 12 months postoperatively. Conclusions: Closure of Petersen's space has an effect on decrease the incidence of gastric food retention after distal gastrectomy with gastrojejunostomy in gastric cancer patients.

Osteopetrosis Tards (만발형골화석증)

  • Kim Young-Hee;Yi Jae-Seo;Yoon Suk-Ja;Kang Byung-Cheol
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.29 no.2
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    • pp.507-521
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    • 1999
  • Osteopetrosis is an uncommon hereditary bone disorder whose prominent radiologic feature characterized by increased bone density. The authors reported a 7-year-old male patient who referred from local dental clinic for dental problems such as early exfoliation of deciduous teeth(#54,73,83) and delayed eruption of permanent teeth(#31.41.36.46). The patient appeared as a poorly developed. Dental X-ray films showed early exfoliation of deciduous teeth, delayed eruption of permanent teeth, and rampant caries. Lateral view of skull demonstrated increased opacity of calvarium, facial bones, and skull base. Generally the skeletal density is greatly increased throughout all bones. Facial CT showed poor development of paranasal sinuses and mastoid air cells. No hematopoietic and neurologic complications such as anemia, thrombocytopenia, blindness and deafness were found. Also mental retardation was not found. The final diagnosis of this case was a osteopetrosis tarda. Sometimes patient with osteopetrosis tarda may be developed dental problems prior to severe systemic symptoms. The dentist can be the first clinician to see the patient. It is very important for the dentist to have the knowledge of the osteopetrosis and to care the patient's dental problems to prevent complication such as osteomyelitis of jaws.

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Delayed Foreign Body Reaction around the Absorbable Implants in Facial Bone Fracture: A Case Report (안면부 골절에 사용된 흡수성 보형물의 지연성 이물반응: 증례보고)

  • Suh, Yong-Hoon;Kim, Young-Joon
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.875-878
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    • 2011
  • Purpose: Absorbable implants are frequently used to fix facial bone fractures, because they are radiolucent and compatible with magnetic resonance imaging (MRI). Despite their increasing usage, however, there have been few reports about their long-term side-effects. In this paper, a case in which absorbable implants led to a foreign body reaction 17 months after their insertion is presented. Methods: A previously healthy 19-year-old male fell from a flight of stairs and visited the authors' hospital with right periorbital pain. Zygomaticomaxillary fracture involving right orbital floor was detected via a facial bone computed tomography (CT). Internal fixation with absorbable implants was followed by open reduction. 17 months after the surgery, the patient complained of localized periorbital swelling. Removal of the granulomatous lesion including the absorbable implants along with their biopsy and culture was performed. Results: The granulomatous lesion around the implants was firm and extended into the maxillary sinus. The histologic finding showed a microabscess with a foreign body reaction. Methicillin-sensitive Staphylococcus aureus growth was confirmed in the culture. No definite abnormal symptoms ensued after the complete removal. Conclusion: A microabscess-forming granulomatous lesion around the absorbable implant can cause delayed symptomatic foreign body reaction despite its rare occurrence. Complete removal of the lesion including implants is expected to have a successful outcome if it is encountered.

Delayed Bronchoplasty in Complete Transection of Left Main Bronchus after Blunt Trauma (외상성 좌측주기관지 절단환자의 지연수술 치험)

  • 김명천;이재영;조규식;박주철;유세영
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.182-185
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    • 1998
  • Recently, The non-penetrating injury of bronchus has been increased, especially by traffic accident. Early diagnosis and primary repair of bronchial injury not only restore normal lung function but also avoid the difficulties and complications associated with delayed diagnosis and repair. This report describes about a case of total collapse and consolidation of left lung with the complete transection of nearly bifurcated portion of left main bronchus , lasted for 2weeks after traffic accident. This was diagnosed by fiberbronchoscopy and 3-D chest computed tomography(CT). She underwent the sleeve resection and end to end anastomosis, and postoperative PEEP for 2 days, suctioning twice by fiberbronchoscopy, continue postural drainge and physiotherapy were applied. She had almost full expansion of the left lung at discharge.

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Multiple, Sequential, Remote Intracranial Hematomas Following Cranioplasty

  • Moon, Hong-Joo;Park, Ju-No;Kim, Sang-Dae;Lim, Dong-Jun;Park, Jung-Yul
    • Journal of Korean Neurosurgical Society
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    • v.42 no.3
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    • pp.228-231
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    • 2007
  • The intracranial hemorrhage in regions remote from the site of initial operations is unusual but may present as fatal surgical complication. We report a rare case of multiple, sequential, remote intracranial hematomas after cranioplasty in a patient who did not have any prior risk factors. A 51-years-old man was transferred to the hospital after a head trauma. The brain computed tomography (CT) revealed acute subdural hemorrhage on the right hemisphere with prominent midline shifting. After performing decompressive craniectomy and hematoma removal, the patient recovered without any complications. However, the patient showed neurological deterioration immediately after cranioplasty, which was done three months after the first surgery. There was extensive hemorrhage in the posterior fossa remote from the site of the initial operation site. The brain CT taken soon after removing this hematoma evacuation displayed large epidural hematoma on the left hemisphere. This case represents posterior fossa hemorrhage after supratentorial procedure and sequential delayed hematoma on the contralateral supratentorial region thus seems very rare surgical complications. Despite several possible pathogenetic mechanisms for such remote hematomas, there are usually no clear cut relationships with each case as in our patient. However, for the successful outcome, prompt evaluation and intensive management seem mandatory.

Glioma Mimicking a Hypertensive Intracerebral Hemorrhage

  • Choi, Go;Park, Dong-Hyuk;Kang, Shin-Hyuk;Chung, Yong-Gu
    • Journal of Korean Neurosurgical Society
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    • v.54 no.2
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    • pp.125-127
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    • 2013
  • Here, we report a rare case of an anaplastic astrocytoma masquerading as a hypertensive basal ganglia hemorrhage. A 69-year-old woman who had been under medical management for hypertension during the past 3 years suddenly developed right hemiparesis with dysarthria. Brain computed tomography (CT) scans with contrast and CT angiograms revealed an intracerebral hemorrhage (ICH) in the left basal ganglia, without an underlying lesion. She was treated conservatively, but underwent a ventriculoperitoneal shunt operation 3 months after the initial attack due to deteriorated mental status and chronic hydrocephalus. Three months later, her mental status deteriorated further. Magnetic resonance imaging (MRI) with gadolinium demonstrated an irregular enhanced mass in which the previous hemorrhage occurred. The final histological diagnosis which made by stereotactic biopsy was an anaplastic astrocytoma. In the present case, the diagnosis of a high grade glioma was delayed due to tumor bleeding mimicking hypertensive ICH. Thus, a careful review of neuroradiological images including MRI with a suspicion of tumor bleeding is needed even in the patients with past medical history of hypertension.

A Case Study on the Six Sigma Application to Reduce Waiting Day for Computed Tomography in the Radiology Department (영상의학과 전산화단층촬영 검사 대기일 단축을 위한 6-시그마 적용사례 연구)

  • Seoung, Youl-Hun
    • Journal of the Korea Safety Management & Science
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    • v.12 no.2
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    • pp.225-230
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    • 2010
  • The purpose of the study was to apply and to expand the six sigma to reduce waiting times for computed tomography (CT) examination which manipulated by the department of radiology. It was preceded by DMAIC (Define, Measure, Analyze, Improve, and Control). In the stage of definition, it wereselected for total 5 critical to quality (CTQ), which were the kindness, the waiting time, the examination explanation, the waiting day and the waiting stand environment, that increased the reserved time of CT examination. In the stage of measurement, the number of examinations and of reservation waiting days performed and resulted in final CTQ(Y) which measured each 1.68 and 1.85 sigma. In the stage of analysis, the examination concentrated on morning time, non-scheduled examination of the day, the delayed time of booking, frequent telephone contacting and equipment malfunction were determined as variable key causes. In the stage of improvement, it were performed with expansion of the examination in the morning time, integration of laboratories that used to in each steps, developing the ability of simultaneous booking schedule for the multiple examinations, developing program of examination request, and the customer management team operations. For the control, the number of examinations and reserved waiting days were measured each 3.14 and 1.13 sigma.