A Case of Paraplegia Following Endovascular Stent Repair of Descending Thoracic Aortic Aneurysm

Paraplegia secondary to spinal cord infarction is a recognized complication of open thoracic and thoracoabdominal aortic aneurysm (TAA) repair. TAA is serious and unpredictable condition. Therefore, aortic repair requires thorough information on managing the potential complications will facilitate improve control the problem. We report the symptoms and management of paraplegia in a patient who underwent stent insertion as TAA.

A fractal analysis of bone phantoms from digital images / 대한구강악안면방사선학회지

PURPOSE: (1) To analyse the effect of exposure time, ROI size and one impact factor in the image processing procedure on estimates of fractal dimension; and (2) to analyse the correlated relationship between the fractal dimension and the Cu-Eq value (bone density). MATERIALS AND METHODS: The cylindric bone phantoms of 6 large and 5 small diameter having different bone densities respectively and human dry mandible segment with copper step wedge were radiographed at 1.0 and 1.2 sec esposure (70 kVp, 7 mA) using one occlusal film and digitized. Eleven rectangular ROIs from 11 cylindric bone phantoms and 4 rectangular ROIs from cortical, middle, periodontal regions, and socket of bone were selected. Gaussian blurred Image was subtracted from original image of each ROI and multiplied respectively by 1, 0.8, and 0.5, and then the image was made binary, eroded and dilated once, and skeletonized. The fractal dimension was calculated by means of a box counting method in the software ImageJ. RESULTS: The fractal dimension was decreased gradually with continued bone density decrease showing strong correlations (bone phantom; r> 0.87, bone; r> 0.68) under 70 kVp 1.0 sec M = 0.8. Fractal dimensions showed the significant differerence (p 0.05) under 1.0 sec exposure. CONCLUSIONS: Exposure time, ROI size, and modifying factor during subtracting could become impacting on the results of fractal dimension. Fractal analysis with thoroughly evaluated method considering the various impacting factors on the results could be useful in assessing the bone density in dental radiography.

Cleidocranial dysplasia: a case report / 대한구강악안면방사선학회지

Cleidocranial dysplasia is a rare and autosomal dominent disorder characterized by aplasia or hypoplasia of the clavicles, an open fontanelle, dental abnormalities, and short stature. A 17-year-old female who presented with short stature and subsequent delay in eruption of permanent teeth is described. she showed the abnormal hypermobility of the shoulder, ocular hypertelorism and concave nasal bridge. Radiographs revealed the underdeveloped maxilla, defect of the cranium in the fontanelle region, and aplasia of the clavicles. Characteristically, panoramic view revealed near parallel-sided borders of the ascending ramus and downward curvature of the zygomatic arch with hypoplasia. The prolonged retention of deciduous teeth with delayed eruption of permanent teeth and multiple embedded supernumerary teeth were striking. Radiographic and clinical investigations revealed Cleidocranial dysplasia.

The radiographic localization of unerupted maxillary incisors and supernumeraries / 대한구강악안면방사선학회지

PURPOSE: To evaluate the use of the vertical tube shift from a panoramic film and a periapical film to localize unerupted maxillary incisors and supernumeraries. MATERIALS AND METHODS: The total of 103 displaced maxillary incisors or embedded supernumeraries were examined in this study. The vertical tube shift technique with panoramic and periapical radiography by normal projection taken and compared to localize the position of the embedded maxillary incisors or supernumeraries by a radiologist and 5 general dentists. The gold standard used for the radiographic comparisons was the true position of the embedded tooth as confirmed by horizontal tube shift technique using three periapical radiographs. The general dentist examiners were instructed on the use of the modified acronym "SLDOBU" by the radiologist as it pertains to panoramic radiographs as the principle of vertical tube shift. RESULTS: All of the embedded maxillary incisors and supernumeraries were successfully located using the vertical tube shift from a panoramic and a maxillary anterior periapical radiograph by the radiologist and 5 general dentists. CONCLUSION: The use of a panoramic film with a periapical film combination for a vertical tube shift can be useful to localize unerupted maxillary incisors and supernumeraries.

Clinical Features of Pulmonary Large Cell Neuroendocrine Carcinoma / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: This study was performed to investigate the clinical features of large cell neuroendocrine carcinomas (LCNEC). MATERIALS AND METHODS: We retrospectively reviewed the histopathology and clinical information of 37 patients with LCNEC, diagnosed between June 1992 and May 2002 at the Severance Hospital, and performed immunohistochemical (IHC) staining. RESULTS: The prevalence of LCNEC among primary lung cancers was 0.3%, 37 out of 13, 012 cases over a 10 year period. The mean age was 61+/-12 years old, with 34 (92%) males and 3 (8%) females. 30 patients smoked, with an average of 42 packs per year. A cough was the most frequent symptom. The tumor was located at the periphery of the lung in 24 cases (65%). Among the 30 cases that underwent surgery, 4 were diagnosed pathological stage IA, 11 IB, 1 IIB, 13 IIIA and 1 IIIB. The 7 clinically non-operable cases were IIIB in 3, and IV in 4. The positive rates of CD56, thyroid transcription factor-1 (TTF-1), chromogranin A, synaptophysin and 34betaE12 for tumor cells were 88.9, 55.6, 42.1, 31.6 and 21.1%, respectively, from the IHC staining. The median survival time and 5 year-survival rate were 24 months and 27%, respectively. The group that underwent surgery had a better prognosis than those that did not. CONCLUSION: The positive rates for the tumor markers varied, but those of the CD56 and TFT-1 were the highest. The possibility of LCNEC needs to be evaluated for the following situations: small cell carcinomas located at the periphery and not responding chemotherapy, small cell carcinomas diagnosed by percutaneous needle aspiration, poorly differentiated non-mall cell carcinomas, with uncertain histologic type, and unclassified neuroendocrine tumor, etc.

Relationship between the condyle and adjacent structures in double temporomandibular joint view using panorama / 대한구강악안면방사선학회지

PURPOSE: To investigate the ability of double TMJ view by multifunctional panorama to view the bony components and the space of the temporomandibular joint. MATERIALS AND METHODS: Ten dry skulls fitted with resin shims over the articular surface of the condyle were used to reproduce the temporomandibular joint space. Fine metal wires were attached to the three portions of contours of the condylar head and the articular eminence. With 10 dry skulls and 20 cases having TMJ dysfunction, double TMJ views by multifunctional panorama (Planmeca 2002 Proline CC) and transcranial views were taken, analyzed from the anatomical view point, and compared statistically in view of the widths of the posterior joint space and the condylar head. RESULTS: In double TMJ view, the supero-anterior part of the condyle represented the lateral 1/3, the most superior part represented center portion, and the posterior part medial 1/3 of the condyle. In maximum mouth opening, no other structures were superimposed with the condyle in double TMJ view. In double TMJ view, petrous bone was moderately superimposed with the superior part of the condyle and the posterior increment of angle exposure made wider the images of the articular eminence and the condyle. The tendency of reduction in the posterior joint space appeared in the side of TMJ dysfunction compared with the normal side. The posterior joint spaces in double TMJ view were statistically wider (p<0.05) than those in transcranial view. The correlation coefficient was 0.5179 between the widths of the posterior joint spaces in two radiographic views. CONCLUSIONS: Double TMJ view can be substituted for transcranial view in evaluating the TMJ dysfunction.

Relapsing polychondritis / 대한내과학회지

No abstract available.