• Title/Summary/Keyword: three-dimensional computed tomography

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The structural changes of pharyngeal airway contributing to snoring after orthognathic surgery in skeletal class III patients

  • Park, Jung-Eun;Bae, Seon-Hye;Choi, Young-Jun;Choi, Won-Cheul;Kim, Hye-Won;Lee, Ui-Lyong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.22.1-22.9
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    • 2017
  • Background: Two-jaw surgery including mandibular and maxillary backward movement procedures are commonly performed to correct class III malocclusion. Bimaxillary surgery can reposition the maxillofacial bone together with soft tissue, such as the soft palate and the tongue base. We analyzed changes of pharyngeal airway narrowing to ascertain clinical correlations with the prevalence of snoring after two-jaw surgery. Methods: A prospective clinical study was designed including a survey on snoring and three-dimensional (3D) computed tomography (CT) in class III malocclusion subjects before and after bimaxillary surgery. We conducted an analysis on changes of the posterior pharyngeal space find out clinical correlations with the prevalence of snoring. Results: Among 67 subjects, 12 subjects complained about snoring 5 weeks after the surgical correction, and examining the 12 subjects after 6 months, 6 patients complained about the snoring. The current findings demonstrated the attenuation of the largest transverse width (LTW), anteroposterior length (APL), and cross-sectional area (CSA) following bimaxillary surgery given to class III malocclusion patients, particularly at the retropalatal level. The average distance of maxillary posterior movements were measured to be relatively higher (horizontal distance 3.9 mm, vertical distance 2.6 mm) in case of new snorers. Conclusions: This study found that bimaxillary surgery could lead to the narrowing of upper airway at the retropalatal or retroglossal level as well as triggering snoring in subjects with class III malocclusion. Based on the current clinical findings, we also found that upper airway narrowing at retropalatal level may contribute to increasing the probability of snoring and that polysonography may need to be performed before orthognathic surgery in subjects with class III malocclusion.

Three-dimensional analysis of changes in airway space after bimaxillary orthognathic surgery with maxillomandibular setback and their association with obstructive sleep apnea

  • Jang, Seung-Il;Ahn, Jaemyung;Paeng, Jun Young;Hong, Jongrak
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.33.1-33.11
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    • 2018
  • Background: Bimaxillary orthognathic surgery with maxillomandibular setback is often accompanied by changes in airway space. We analyzed the changes in airway space before and after surgery and assessed their association with obstructive sleep apnea. Methods: This study is based on the cohort of 13 adult patients (9 males, 4 females, average age 23.85 years) who underwent bimaxillary orthognathic surgery with maxillomandibular setback. We performed computed tomography and portable polysomnography before and after the surgery to assess changes in airway space and Apnea-Hypopnea Index (AHI) values (total, supine, non-supine). Results: The oropharyngeal airway volume decreased by 29% after the surgery, which was statistically significant (p < .05). The upper airway volume and hypopharyngeal airway volume were decreased, but not significantly (4 and 19%, respectively). The changes in airway surface area were statistically significant at all levels examined (p < .05). Changes in the maximum anteroposterior width of the airway were also significant at all levels (p < .05). However, the changes in maximum lateral width were only statistically significant at C2 level (p < .05). AHI values were increased after the surgery but not significantly at any position. Conclusions: Although bimaxillary surgery with maxillomandibular setback significantly reduces the airway space, it does not affect AHI values or induce obstructive sleep apnea.

New Carotid Artery Stenosis Measurement Method Using MRA Images (경동맥 MRA 영상을 이용한 새로운 내경 측정 방법)

  • 김도연;박종원
    • Journal of KIISE:Software and Applications
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    • v.30 no.12
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    • pp.1247-1254
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    • 2003
  • Currently. the north american symptomatic carotid endarterectomy trial, european carotid surgery trial, and common carotid method are used to measure the carotid stenosis for determining candidate for carotid endarterectomy using the projection angiography from different modalities such as digital subtraction angiography. rotational angiography, computed tomography angiography and magnetic resonance angiography. A new computerized carotid stenosis measuring system was developed using MR angiography axial image to overcome the drawbacks of conventional carotid stenosis measuring methods, to reduce the variability of inter-observer and intra-observer. The gray-level thresholding is one of the most popular and efficient method for image segmentation. We segmented the carotid artery and lumen from three-dimensional time-of-flight MRA axial image using gray-level thresholding technique. Using the measured intima-media thickness value of common carotid artery for each cases, we separated carotid artery wall from the segmented carotid artery region. After that, the regions of segmented carotid without artery wall were divided into region of blood flow and plaque. The calculation of carotid stenosis degree was performed as the following; carotid stenosis grading is(area measure of plaque/area measure of blood flow region and plaque) * 100%.

A Study of 3D Printing of Self-Customization Cast by Using Fused Deposition Modeling Technique of ABS Resin (ABS 수지의 용융적층조형방식에 의한 자가 맞춤형 부목의 3차원 출력 사례 연구)

  • Seoung, Youl-Hun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.9
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    • pp.6019-6026
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    • 2015
  • In this study, we have tried to use 3D-printing technology, which is very useful for small amount production and individual personalization manufacturing to produce a cast customized by individual. To do this, we have made casts by the 3D printer in the method of fused deposition modeling technique using ABS(acrylonitrile butadiene styrene) resin which is thermoplastic plastics. The computed tomography of human hand part was used as the modeling of the cast and it was designed to circulate air well. As a result, an individual personalized cast that fitted well with the model part was produced. In addition, we could get more excellent radiography from the cast than the existing cast. In conclusion, this study of 3D-printing could be used as basic data when a similar designed structure in fused deposition modeling technique by ABS resin is printed out.

Clinical Experience of the Brushite Calcium Phosphate Cement for the Repair and Augmentation of Surgically Induced Cranial Defects Following the Pterional Craniotomy

  • Ji, Cheol;Ahn, Jae-Geun
    • Journal of Korean Neurosurgical Society
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    • v.47 no.3
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    • pp.180-184
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    • 2010
  • Objective : To prevent temporal depression after the pterional craniotomy, this study was designed to examine the safety and aesthetic efficacy of the brushite calcium phosphate cement (CPC) in the repair and augmentation of bone defects following the pterional craniotomy. Methods : The brushite CPC was used for the repair of surgically induced cranial defects, with or without augmentation, in 17 cases of pterional approach between March, 2005 and December, 2006. The average follow-up month was 20 with range of 12-36 months. In the first 5 cases, bone defects were repaired with only brushite CPC following the contour of the original bone. In the next 12 cases, bone defects were augmented with the brushite CPC rather than original bone contour. For a stability monitoring of the implanted brushite CPC, post-implantation evaluations including serial X-ray, repeated physical examination for aesthetic efficacy, and three-dimensional computed tomography (3D-CT) were taken 1 year after the implantation. Results : The brushite CPC paste provided precise and easy contouring in restoration of the bony defect site. No adverse effects such as infection or inflammation were noticed during the follow-up periods from all patients. 3D-CT was taken 1 year subsequent to implantation showed good preservation of the brushite CPC restoration material. In the cases of the augmentation group, aesthetic outcomes were superior compared to the simple repair group. Conclusion : The results of this clinical study indicate that the brushite CPC is a biocompatible alloplastic material, which is useful for prevention of temporal depression after pterional craniotomy. Additional study is required to determine the long-term stability and effectiveness of the brushite calcium phosphate cement for the replacement of bone.

Morphometric Variations in the Volar Aspect of the Distal Radius

  • Kwon, Bong Cheol;Lee, Joon Kyu;Lee, Suk Yoon;Hwang, Jae Yeun;Seo, Jang-Hyeon
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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    • pp.462-467
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    • 2018
  • Background: Significant discrepancy exists between anatomical plate designs and the anatomy of the native distal radius, which may be attributable to considerable morphometric variations in the volar aspect of the distal radius. We aimed to evaluate the degree of variability in the morphometry of the distal radius and identify factors associated with this variability. Methods: We measured the volar surface angle (VSA) of the intermediate and lateral columns and the volar surface width (VSW) in the distal radius from three-dimensional computed tomography scans acquired from 81 cadaveric forearms. These morphometric parameters were compared between the lateral and intermediate columns, between males and females, and between Koreans and Caucasians. Caucasian morphometric data were obtained and pooled from the previous studies. The coefficient of variation was used to assess the variability of the parameters and Cohen's d to estimate the effect size of the difference between groups. Results: The average VSA of the lateral column was $22^{\circ}{\pm}6^{\circ}$, and that of the intermediate column was $29^{\circ}{\pm}8^{\circ}$ in Koreans (p < 0.001). The variability was high for both VSAs. The VSA of the intermediate column was significantly larger in males than in females (p < 0.001) and in Caucasians than in Koreans (p < 0.001). The average VSW of distal radius was $30{\pm}3mm$ at the watershed line, and it became narrower proximally. The VSW was significantly larger in males than in females (p < 0.001) and in Koreans than in Caucasians (p < 0.001). The effect sizes of the difference for the VSA and VSW between sexes, races and columns were medium to large. Conclusions: Considerable variability exists in the morphometry of the volar distal radius, with sex, race, and column as contributing factors. These results suggest that surgeons should carefully choose an anatomical volar locking plate with appropriate angulation characteristics for each patient to achieve patient-specific alignment of the distal radius.

Evaluation of Adult Lung CT Image for Ultra-Low-Dose CT Using Deep Learning Based Reconstruction

  • JO, Jun-Ho;MIN, Hyo-June;JEON, Kwang-Ho;KIM, Yu-Jin;LEE, Sang-Hyeok;KIM, Mi-Sung;JEON, Pil-Hyun;KIM, Daehong;BAEK, Cheol-Ha;LEE, Hakjae
    • Korean Journal of Artificial Intelligence
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    • v.9 no.2
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    • pp.1-5
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    • 2021
  • Although CT has an advantage in describing the three-dimensional anatomical structure of the human body, it also has a disadvantage in that high doses are exposed to the patient. Recently, a deep learning-based image reconstruction method has been used to reduce patient dose. The purpose of this study is to analyze the dose reduction and image quality improvement of deep learning-based reconstruction (DLR) on the adult's chest CT examination. Adult lung phantom was used for image acquisition and analysis. Lung phantom was scanned at ultra-low-dose (ULD), low-dose (LD), and standard dose (SD) modes, and images were reconstructed using FBP (Filtered back projection), IR (Iterative reconstruction), DLR (Deep learning reconstruction) algorithms. Image quality variations with respect to varying imaging doses were evaluated using noise and SNR. At ULD mode, the noise of the DLR image was reduced by 62.42% compared to the FBP image, and at SD mode, the SNR of the DLR image was increased by 159.60% compared to the SNR of the FBP image. Based on this study, it is anticipated that the DLR will not only substantially reduce the chest CT dose but also drastic improvement of the image quality.

Biomechanical Analysis of Biodegradable Cervical Plates Developed for Anterior Cervical Discectomy and Fusion

  • Cho, Pyung Goo;Ji, Gyu Yeul;Park, Sang Hyuk;Shin, Dong Ah
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1092-1099
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    • 2018
  • Study Design: In-vitro biomechanical investigation. Purpose: To evaluate the biomechanical effects of the degeneration of the biodegradable cervical plates developed for anterior cervical discectomy and fusion (ACDF) on fusion and adjacent levels. Overview of Literature: Biodegradable implants have been recently introduced for cervical spine surgery. However, their effectiveness and safety remains unclear. Methods: A linear three-dimensional finite element (FE) model of the lower cervical spine, comprising the C4-C6 vertebrae was developed using computed tomography images of a 46-year-old woman. The model was validated by comparison with previous reports. Four models of ACDF were analyzed and compared: (1) a titanium plate and bone block (Tita), (2) strong biodegradable plate and bone block (PLA-4G) that represents the early state of the biodegradable plate with full strength, (3) weak biodegradable plate and bone block (PLA-1G) that represents the late state of the biodegradable plate with decreased strength, and (4) stand-alone bone block (Bloc). FE analysis was performed to investigate the relative motion and intervertebral disc stress at the surgical (C5-C6 segment) and adjacent (C4-C5 segment) levels. Results: The Tita and PLA-4G models were superior to the other models in terms of higher segment stiffness, smaller relative motion, and lower bone stress at the surgical level. However, the maximal von Mises stress at the intervertebral disc at the adjacent level was significantly higher in the Tita and PLA-4G models than in the other models. The relative motion at the adjacent level was significantly lower in the PLA-1G and Bloc models than in the other models. Conclusions: The use of biodegradable plates will enhance spinal fusion in the initial stronger period and prevent adjacent segment degeneration in the later, weaker period.

Surgical Treatment for a Huge Maxillary Ameloblastoma via Le Fort I Osteotomy: A Case Report

  • Jung, Sang-pil;Jee, Yu-jin;Lee, Deok won;Kim, Hyung Kyung;Kang, Miju;Kim, Se-won;Yang, Sunin;Ryu, Dong-mok
    • Journal of Korean Dental Science
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    • v.11 no.2
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    • pp.86-91
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    • 2018
  • Ameloblastomaa are odontogenic benign tumors with epithelial origin, which are characterized by slow, aggressive, and invasive growth. Most ameloblastomas occur in the mandible, and their prevalence in the maxilla is low. A 27-year-old male visited our clinic with a chief complaint of the left side nasal airway obstruction. Three-dimensional computed tomography showed left maxillary sinus filled with a mass. Except for the perforated maxillary left edentulous area, no invaded or destructed bone was noted. The tumor was excised via Le Fort I osteotomy. The main mass was then sent for biopsy and it revealed acanthomatous ameloblastoma. The lesion in the left maxillary sinus reached the ethmoidal sinus through the nasal cavity but did not invade the orbit and skull base. The tumor was accessed through a Le Fort I downfracture in consideration of the growth pattern and range of invasion. The operation site healed without aesthetic appearances and functional impairments. However, further long-term clinical observation is necessary in the future for the recurrence of ameloblastoma. Conservative surgical treatment could be the first choice considering fast recovery after surgery and the patient's life quality.

Convergence and integration study related to development of digital contents for radiography training using dental radiograph and augmented reality (치과방사선사진과 증강현실을 활용한 방사선촬영법 숙련용 디지털 콘텐츠 개발에 대한 융복합 연구)

  • Gu, Ja-Young;Lee, Jae-Gi
    • Journal of Digital Convergence
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    • v.16 no.12
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    • pp.441-447
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    • 2018
  • This study aims to develop digital techniques that enable repeated practice of dental radiography using augmented reality technology. A three-dimensional object was fabricated by superimposing a photograph of an adult model and a computed tomography image of a manikin phantom. The system was structured using 106 radiographs such that one of these saved radiographs is opened when the user attempts to take a radiograph on a mobile device. This system enabled users to repeatedly practice at the pre-clinical stage without exposure to radiation. We attempt to contribute to enhancing dental hygienists' competency in dental radiography using these techniques. However, a system that enables the user to actually take a radiograph based on face recognition would be more useful in terms of practice, so additional studies are needed on the topic.