• Title/Summary/Keyword: x-ray CT

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Improvement of the Trauma Care Process by Implementation of a Computerized Physician Order Entry-Based Trauma Team Approach

  • Lee, Ji-hwan;Lee, Jin-hee;You, Je-sung;Chung, Sung-phil;Kim, Hyun-jong;Cho, Jun-ho;Kim, Min-joung;Chung, Hyun-soo
    • Quality Improvement in Health Care
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    • v.21 no.2
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    • pp.12-24
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    • 2015
  • Purpose: The need for the rapid evaluation and treatment of emergency department patients with major trauma is essential. A computerized physician order entry (CPOE) system can improve communication and provide immediate access to information with the goal of reducing ED time delays. The aim of this study was to report on the operation of a trauma CPOE program and demonstrate its usefulness by comparing time intervals from ED arrival to various evaluation steps before and after implementation of the program. Methods: This was a before-and-after observational study from a single emergency department at an academic center. The CPOE program was implemented for 6 months and compared with the data collected from the pre-CPOE implementation period. The efficacy of the program was assessed by comparing the time difference before and after CPOE implementation based on the following factors: total boarding time in ED, door-to-disposition decision time, door-to-blood-test report time, door-to-X-ray time, door-to-CT time, and door-to-transfusion time. Results: Over a period of 6 months, the CPOE was activated for a total of 17 patients. Total boarding time was reduced significantly after implementation [median, 641.5 minutes (IQR, 367.3-859.3) versus289.0 minutes (IQR, 140.0-508.0) for pre-CPOE vs. post-CPOE, respectively, p< 0.05). Time intervals for all evaluation steps were reduced after implementation of the program. The improvements in the door-to-blood-test and door-to-CT times were both statistically significant. Conclusion: This study demonstrated that a standard CPOE system can be successfully implemented and can reduce ED time delays in managing trauma patients.

Benign Tumor-Like Developmental Salivary Gland Defect (양성 종양과 유사한 형태를 가진 발육성 타액선 골결손)

  • An, Seo-Young;Kim, Yong-Gun;Jung, Jae-Kwang
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.3
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    • pp.301-307
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    • 2012
  • 50-year-old female and 50-year-old male were referred to the department of the oral and maxillofacial surgery of Kyungpook national university dental hospital with asymptomatic lesions on their posterior mandibular body areas. They were discovered incidentally on panoramic radiographs during routine dental examination. Physical examination revealed no remarkable findings. Each panoramic radiograph showed well defined radiolucent lesions without hyperostotic border on their posterior mandibular body area. At first they were diagnosed as benign tumors because they looked like multilocular pattern and one of the patient showed discontinuity of mandibular canal within the lesion. CT scans demonstrated well demarcated and irregular lingual depression filled with fat tissue and they were diagnosed as developmental salivary gland defects. One of the lesion showed no change on follow-up panoramic radiograph after 4 months. Developmental salivary gland defects resembling benign tumor are atypical cases and it is suggested that confirmatory imaging using CT or MRI should be taken.

A Case of Extensive Stage Small Cell Lung Cancer Presenting as an Acute Appendicitis with Perforation (전이성 병소에 의해 발생한 급성 충수염의 천공으로 진단된 전신병기 소세포폐암 1예)

  • Shin, Dong Won;Choi, Moon Han;Park, Seung Sik;Park, Sung Woo;Kim, Ki Up;Jang, An Soo;Park, Choon-Sik;Lim, Cheol Wan;Ko, Eun Suk;Paik, Sang Hyun;Kim, Do Jin
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.3
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    • pp.230-234
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    • 2008
  • The incidence of appendiceal metastatic cancer is quite low. In particular, in small cell lung cancer, there is a very low incidence of a metastasis to the appendix. A 75-years old man with right lower quadrant pain, cough and sputum was transferred to our hospital. Abdominal CT revealed acute appendicitis with a perforation. The patient underwent surgery. The frozen sections of the tissue obtained during surgery, indicated a malignancy, but a right hemicolectomy was not performed due to the patient's poor general condition. The histology findings of the appendix were identified as a small cell carcinoma. The abdominal CT scan and chest x-ray at admission day showed a mass in the right lower lobe, and a further evaluation of the lesion was performed including positron emission tomography and flexible bronchoscopy with a biopsy. The pathology findings of the lung mass were also small cell lung cancer. The specimens from both sites stained positive for cytokeratin, cluster designation 56, synaptophysin, chromogranin-A and thyroid transcription factor 1. It was concluded that the appendiceal small cell cancer originated from the lung.

A Case of Primary Diffuse Nodular Pulmonary Amyloidosis Localized in the Lung (원발성 결절성 폐실질형 유전분증 1예)

  • Jung, Sung-Kwoen;Oh, Joon;Roh, Yang-Won;Kong, Hee-Sang;Park, Kae-Young;Park, Jeong-Woong;Park, Jae-Kyung;Nam, Gui-Hyun;Ha, Seong-Hwen;Lee, Han-Kyung;Jeong, Seong-Hwan
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.3
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    • pp.365-371
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    • 2000
  • Nodular pulmonary amyloidosis is one of the rare manifestation of amyloid disease. It is known to be caused by amyloid L fibrils in the majority of cases. We experienced an unusual case of a forty-one year-old woman who was presented with multiple nodular lesion on the chest X-ray. CT-guided core needle biopsy, performed on the lesion, showed apple green birefringes, when stained Congo red and examined under polarized light, Ultrastructurally, there are randomly oriented, forming densed networks, and consists of fine, 7.5 to 10nm diameter, rigid, non-branching filaments of various lengths in electron-microscopic finding. We report a case of primary diffuse nodular pulmonary amyloidosis only localized in the lung, which was confirmed by CT guided core needle biopsy.

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The Effect of Irradiation and Cis-diamminedichloroplatinum(II) in the Rat Brain : Analysis of Histopathology at 3 and 6 Months after Treatment (횐쥐 뇌에 방사선조사와 Cis-diamminedichloroplatinum(II)의 효과 : 치료 후 3개월과 6개월에서의 조직학적분석)

  • Lee Kyung-Ja;Chang Seung-Hee;Koo Heasoo
    • Radiation Oncology Journal
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    • v.16 no.2
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    • pp.125-138
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    • 1998
  • Purpose : To evaluate the late effect(3 and 6 months) of cis-diarnrninedichlo-roplatinum(II)(cisplatin) on the radiation brain damage when the cisplatin was intraperitoneally infused immediately after whole brain irradiation in the rats. Materials and Methods : The histolopathological findings of the brain were examined in rat brains at 3 and 6 months after the treatment. The rats were irradiated(20 or 22.5 Gy, RT) or cisplatin was injected intraperitoneally(2,4, or 8mg/kg, CT) and in combined treatment group, cisplatin(2mg/kg) was injected immediately after irradiation(20 or 22.5 Gr). Histopathological examination was done mostly in irradiation or cisplatin alone groups, because the rats in combined group died during experimental period except 2 rats. Results : The rats treated with cisplatin showed marked epithelial vacuolation with perivascular edema and vascular dilatation in choroid plexus at 3 months as well as multifocal necrosis involving fimbria and cerebellar hemispheres at 3 and 6 months. The changes were more prominent in rats with 2mg/kg injection compared to rats with 8mg/kg injection. The rats with RT and combined CT and RT showed characteristic delayed irradiation effects such as focal coagulation necrosis and vascular changes, which were more marked than previous reports Prominent perivascular and leptomenin-geal astrocytic Proliferation was well documented by anti-GFAP antibody. Cisplatin treatment did not enhance the effect of radiation-induced changes of blood vessels and astrocytic proliferation. Conclusion : The focal necrosis was the most consistently noted finding in this study, it suggested the possibility to use this as an evaluation factor for combined effects of RT and cisplatin.

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THE DIAGNOSIS OF IMPACTED MAXILLARY MESIODENS USING 3-DIMENSIONAL COMPUTED TOMOGRAPHY : A CASE REPORT (3차원 전산화 단층촬영을 이용한 상악 정중 과잉치의 진단)

  • Hong, Young-Woo;Kim, Seong-Oh;Sohn, Hyung-Kyu;Lee, Jong-Gap
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.3
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    • pp.549-554
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    • 1998
  • The prevalence of the supernumerary tooth is $1{\sim}4%$. It usually occurs in the permanent dentition. It frequently occurs in the maxillary mid palatal area. The presence of the supernumerary tooth causes the following problems ; (1) interfering the eruption of successional tooth, (2) displacing the neighboring teeth, (3) resulting large diastema, (4) forming cystic change. So the supernumerary tooth should be removed as soon as possible. To extract the supernumerary tooth, the exact position must be noticed first. Radiographic techniques that were used in the past are tube shift technique, right angle technique, sterioradiography, using radiopaque contrast media and conventional tomography. But these methods include the subjective opinion of the operator. So, a technique eliminating the operator's opinion and showing the position 3-dimentionally can be used. 3-dimentional computed tomography equipped with dental softwares can show the position of the impacted supernumerally tooth in 3-dimentional position. It has an advantage to eliminate the subjective opinion of the operator. With a fast computer this techenique is done in a relatively short period of time. The rationale of this methods is relatively simple. After tacking X-ray and reconstructing the data 3-dimentionally, sequential removal of the soft tissue and hard tissue(bone) CT number leaves the teeth alone in 3-dimentional position. The image can be seen from anywhere, so the operator can see the image in front, rear, upper, and lower positions. In both cases 1 and 2, the position of the impacted supernumerary tooth is viewed by the 3-dimensional computed tomography. And it made the operator easy to figureout the exact position.

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Tracheal Resection and End to End Anastomosis for Tracheal Stenosis in Children (기관절제 및 단단문합술에 의한 소아 기관협착증의 치료)

  • Choi, Jong-Ouck;Chung, Keun;Kim, Young-Hwoan;Kim, Hye-Jung;Park, Chan;Choi, Geon
    • Korean Journal of Bronchoesophagology
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    • v.3 no.1
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    • pp.94-100
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    • 1997
  • Background and Objectives : In children with tracheal stenosis, operative management remains a challenging problem due to difficulties of operative techniques and postoperative care. The purpose of this study was to determine the effectiveness of tracheal resection with end to end anastomosis as operative management for tracheal stenosis in children. Materials and Methods : 6 children with severe tracheal stenosis underwent tracheal resection with end to end anastomosis. Causes of stenosis were trauma in 1 case and prolonged intubation or tracheotomy in 5 cases. The diagnoses were made by radiologic evaluation (plain X-ray, CT, 3-Dimensional CT) and confirmed by direct laryngoscopy and ventilating bronchoscopy under general anesthesia. Thyroplasty and unilateral arytenoidectomy were performed in 1 case. Suprahyoid release was done in 1 case with severe adhesion. Decanulation was achieved following postoperative endoscopic examination and pulmonary function test. Postoperative physical and radiologic examinations were given at regular intervals. Results : Stenosis were improved from grade III grade I in 4 cases and from grade II to grade I in 2 cases. Decanulation was achieved on average postoperative 6 months in 5 cases, and 10 years in 1 case due to exertional dyspnea. There were 1 each case of immediate postoperative subcutaneous emphysema, pneumothorax and wound infection. Postoperative granulomas at anastomosis site were treated with laser vaporization under suspension laryngoscope and bronchoscope in 3 cases. There was 1 each case of delayed postoperative vocal cord palsy, aspiration pneumonia and loss of cough reflex. Conclusion In tracheal stenosis of children, tracheal resection with end to end anastomosis has good result with preservation of normal airway. Preoperative evaluation of local factors such as swallowing, vocal cord movement and cough reflex and general condition was important for successful treatment. As the cases in adults, authors considered this operation to be a curable operative management for tracheal stenosis.

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The effects of zoledronic acid on the progression of experimental periodontitis in rats: histological and microtomographic analyses

  • de Marcelos, Priscylla Goncalves Correia Leite;da Cruz Perez, Danyel Elias;Soares, Diego Moura;de Araujo, Samuel Silva;Evencio, Liriane Baratella;Pontual, Maria Luiza dos Anjos;Ramos-Perez, Flavia Maria de Moraes
    • Journal of Periodontal and Implant Science
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    • v.51 no.4
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    • pp.264-275
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    • 2021
  • Purpose: Periodontitis is considered a local risk factor for medication-related osteonecrosis of the jaws (MRONJ). However, little is known about the progression of periodontitis in the presence of zoledronic acid (ZOL). The aim of this study was to evaluate the effects of the systemic use of ZOL on the progression of experimental periodontitis (EP) in rats, as ZOL could modulate the progression of periodontitis and concomitantly cause MRONJ in individuals with periodontitis. Methods: Forty-eight male Wistar rats were randomly distributed in 6 groups (n=8 each). To induce EP, ligatures were placed around the right first mandibular molars. Three groups were treated with ZOL (0.15 mg/kg/week, intraperitoneal), and 3 with 0.9% saline solution (controls). In the ZOL/Lig30 and ZOL/Lig 15 groups, after 4 weeks of treatment with ZOL, EP was induced and euthanasia was performed after 30 and 15 days of EP induction, respectively. In both groups, the animals continued to receive ZOL after EP until the end of the experiment. In the Lig/ZOL group, EP was induced first, and 15 days later, ZOL was administered for 8 weeks, with euthanasia 1 week after the last dose. After euthanasia, the mandibles were evaluated using micro-computed microtomography (micro-CT) and histomorphometry. Bone loss was measured, and the presence of osteonecrosis was evaluated histologically. The data were evaluated using the Student t-test and the Mann-Whitney test, with a significance level of 5%. Results: In the Lig/ZOL group, micro-CT revealed less alveolar bone resorption in the distal root (P<0.01) than in the control group (Lig/Con). Histomorphometric analysis confirmed less alveolar bone resorption in the Lig/ZOL group (P=0.001). Histologically, osteonecrosis was more common in the ZOL groups. Conclusion: ZOL decreased alveolar bone resorption in rats with EP. However, it presented a higher risk for MRONJ.

Layered Double Hydroxide Nanoparticles for Bio-Imaging Applications (LDH 나노입자 기반의 바이오 이미징 소재)

  • Jin, Wenji;Ha, Seongjin;Lee, Dongki;Park, Dae-Hwan
    • Korean Chemical Engineering Research
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    • v.57 no.4
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    • pp.445-454
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    • 2019
  • Layered double hydroxides (LDHs) nanoparticles have emerged as novel nanomaterials for bio-imaging applications due to its unique layered structure, physicochemical properties, and good biocompatibility. Bio-imaging is one of the most important fields for medical applications in clinical diagnostics and therapeutics of various diseases. Enhanced diagnostic techniques are needed to realize new paradigm for next-generation personalized medicine through nanoscale materials. When nanotechnology is introduced into bio-imaging system, nanoparticle probes can endow imaging techniques with enhanced ability to obtain information about biological system at the molecular level. In this review, we summarize structural features of LDH nanoparticles with current issues of bio-imaging system. LDH nanoparticle probes are also discussed through in vitro as well as in vivo studies in various bio-imaging techniques including fluorescence imaging, magnetic resonance imaging (MRI), positron emission tomography (PET), and computed X-ray tomography (CT), which will have the potential in the development of the advanced nanoparticles with high sensitivity and selectivity.

A Study on the Luminescence Properties of Eu3+ Ions Doped Vanadate (Eu3+ 이온이 첨가된 바나듐산염의 형광특성 연구)

  • Kang, Yeonhee;Yoon, Changyong
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.445-451
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    • 2019
  • The fluorescence intensity and fluorescence lifetime of $Ba_2GdV_3O_{11}$, a vanadate compound based on $Ba^{2+}$ ion, were investigated by adding $Eu^{3+}$ as a rare earth ion which is an alkaline earth metal, which is distributed around active ions and has a large influence on fluorescent properties when used as a host in a phosphor. $Ba_2GdV_3O_{11}:Eu^{3+}$ phosphor was synthesized by solid state method and the crystallinity of the phosphor was confirmed by X - ray diffraction analysis. The fluorescence properties of the $Ba_2GdV_3O_{11}:Eu^{3+}$ phosphor were measured using optical and laser. The energy transfer and diffusion of the $Ba_2GdV_3O_{11}:Eu^{3+}$ phosphor are highly dependent on the concentration of $Eu^{3+}$. When the concentration of $Eu^{3+}$ is low, it shows strong fluorescence to the CT band. However, as the concentration of $Eu^{3+}$ increases, the fluorescence due to 4f - 4f transition is strong. The concentration of $Eu^{3+}$ ion increased and the energy between ions was diffused, and the lifetime of fluorescence decreased. Energy transfer occurs between two $Eu^{3+}$ ions at low $Eu^{3+}$ concentration and energy diffusion occurs at high $Eu^{3+}$ concentration.