Computed Tomographic Study of Occipital Thickness in Ethnic Malays

@#Introduction: Occipitocervical fusion is performed to address craniocervical and atlantoaxial instability. A screw of at least 8mm is needed for biomechanical stability. Occipital thickness of Malay ethnicity is unknown, and this study presents the optimal screw placement positions for occiput screw in this population. This was a retrospective crosssectional study of 100 Malays who underwent computed tomography (CT) scan for brain assessment. To measure the occipital bone thickness of Malay ethnicity at the area of common screw placement for occipitocervical fusion. The subject’s data was obtained from the institutional database with consent from the administrations and the patients. None of the patients had any head and neck pathology. Materials and methods: The subject’s data was obtained from the institutional database with consent from the administrations and the patients. None of the patients had any head and neck pathology. Computed tomography (CT) of 100 Malay patients who underwent head and neck CT were analysed, based on our inclusion and exclusion criteria. Measurements were taken using a specialised viewer software where 55 points were measured, followed a grid with 10mm distance using external occipital protuberance (EOP) as the reference point. Results: There were 57 males and 43 females of Malay ethnicity with a mean age of 36.7 years analysed in this study. The EOP was the thickest bone of the occiput which measured 16.15mm. There was an area of at least 8mm thickness up to 20mm on either side of the EOP, and at level 10mm inferior to the EOP. There is thickness of at least 8mm, up to 30mm inferior to the EOP at the midline. The males have significantly thicker bone especially along the midline compared to females. Conclusion: Screws of at least 8mm can be safely inserted in the Malay population at 20mm on either side of the EOP at the level 10mm inferior to the EOP and up to 30mm inferior to the EOP at the midline.

Combined pulmonary fibrosis and emphysema with pulmonary arterial hypertension: A Rare Case Report.

Combined pulmonary fi brosis and emphysema (CPFE) is a recently recognized radiologically defi ned syndrome characterized by simultaneous coexistence of both upper lobe emphysema and lower lobe pulmonary fi brosis. We present a case of CPFE in a 57-year-old male smoker who presented with dry cough, progressive breathlessness, and swelling of feet. His chest X-ray revealed bilateral lower Zone reticulonodular opacities with hyperlucent upper Zones. Pulmonary function tests showed wellpreserved lung volumes and reduced diff using capacity of the lung for carbon monoxide. High-resolution computed tomogram showed bilateral lower lobe subpleural honeycombing along with fi brosis and traction bronchiectasis with bilateral upper lobe emphysema predominantly paraseptal type. His 2D echo was suggestive of moderate pulmonary arterial hypertension.

Thymic atypical carcinoid.

Only 2% of carcinoids originate from the thymus with an estimated incidence of 1.5 to 3 per 10,000,000 persons per year. We present the case of a 30-year-old female patient in whom the diagnosis was confirmed by a fine needle aspiration cytology of a large mediastinal mass.

Acute Appendicitis in Children: Comparison between Present and 10 Year Ago

Appendicitis is the most common surgical emergency in childhood and the technologic advances of modern medicine have affected the diagnosis and treatment of appendicitis. This study is to evaluate the differences in diagnosis and treatment of appendicitis between present and 10 year ago. The authors retrospectively reviewed the medical records of patients who underwent appendectomy under the diagnosis of the acute appendicitis from July 1993 to June 1995 (Group A, n = 78) and from July 200 to June 2005 (Group B, n = 105). There are no differences between group A and B in mean age (8.5 +/-3.6 vs. 9.3 +/-3.1 year), duration of symptoms (3.0 +/-3.2 vs. 2.6 +/-3.8 days), and postoperative hospital stay(6.6 +/-4.8 vs. 5.8 +/-3.6 days). Preoperative abdominal ultrasonogram and/or computed tomogram was performed in 7 patients (9.0 %) of group A and in 51 patients (58.5 %) of group B. Thirty-six patients (34.3 %) of group B underwent laparoscopic appendectomy, but none in group A. Incidence of a histologically normal appendix decreased from 15.8 % in group A to 4.8 % in group B (p =0.018). This study suggests that utilization of abdominal ultrasonogram or computed tomogram in preoperative evaluation become more popular and surgical treatment of acute appendicitis become more minimally invasive. The rate of negative appendectomy was also reduced compared with 10 year ago.

Study for hounsfield units in computed tomogram with jaw lesion

The CT number is called Hounsfield unit(HU). Generally HU has a score between +1000 from -1000, and it is standardized usingthe air(-1000), water(0), and compact bone(+1000). Hounsfield Unit to standardize the density in computed tomography using the air and water has been used to analysis of lesion in other medical field. Computed tomography is popular method to analysis of lesion in oral and maxillofacial field but the analysis about density of lesion by Hounsfield unit is still obscure. For this study, computed tomography taken in Dankook University Dental Hospital and Hounsfield unit was measured to compare the difference of jaw bone lesion as cystic lesion, benign tumor, malignant tumor.

Correlation between risk of atherosclerosis and anthropometric parameters in premenopausal women

BACKGROUND: Hypertension, diabetes, hyperlipidemia and coronary heart disease are closely related to obesity. Recently incidence of such diseases are remarkably increased. Many researches have been done to find out to implement prevention and treatment of such diseases. Abdominal obesity is one of the most important contributing factors of metabolic complications. This study was done to compare indicators of obesity with abdominal fat amount which was measured by anthropometric parameters and computed tomogram, and to find correlation between the risk factors of atherosclerosis and the indicators of obesity. METHODS: Fifty nine healthy premenopausal women without diabetes, coronary heart disease or history of other chronic disease were enrolled. Blood pressure and simple anthropometric parameter were measured. Computed tomograms in umbilical and femoral regions were performed. From serial blood samples, plasma fasting glucose and insulin, cholesterol and triglyceride were measured and atherogenic index was calculated. RESULTS: The ratio of visceral fat area and skeletal muscle area at the mid-thigh level was found to be highly correlated(R=0.965, p<0.001) and atherogenic index showed similar patterns to the waist circumference, the waist/height ratio and the waist/hip ratio. Especially, the waist/height ratio was found to be the most reliable indicator of obesity to predict atherogenic index. CONCLUSION: Although the ratio of visceral fat and skeletal muscle areas at the mid-thigh level which is measured by computed tomogram was the best indicator of visceral fat, these results proved that waist circumference and the waist/height ratio were also good indicators of the risk factors of atherosclerosis. By simple anthropometric measurements, it can help to find the remedy and preventiono of obesity in primary practices.

Hepatic Fascioliasis Mimicking Metastatic Tumor

A case of hepatic fascioliasis misdiagnosed as metastatic carcinoma was reported. The patient was a 22-year-old woman who had had rectal adenocarcinoma (Duke stage C2), and had been treated by Mile'operation 8 months ago. A computed tomogram(CT) demonstrated multiple low density nodules in the liver suggesting a metastatic tumor. A partial liver lobectomy was performed. The resected liver showed multiple necrotic nodules, which appeared to be abscesses containing eggs of the Fasciola species. Parasitic infection should be considered as one of the possible etiologies of hepatic nodules which mimic metastatic carcinoma either clinically or radiologically.

Cross-sectional illustration on major types of conjoined twins

Conjoined twins show varying degree of conjoining in either facing or side-by-side fashion. Cephalothoracopagus janiceps is a prototype of facing anomaly in which the two bodies demonstrated a cross symmetry to the midline, that is axial symmetry. Interfacial and intersternal lines crossed at a right angle and no abnormality of situs was associated. Dicephalus dipus dibrachius is a case of side-by-side union, in which the bodies facing nearly the same direction were symmetrical to the middle sagittal plane. Abnormal situs of one was always associated. Other types of conjoined twins as thoracopagus lie between the two extremes of facing and side-by-side union. The three dimensional architectures of the organs in each type would be explained using cross sectional figures of skull, thorax and pelvis. Although the facing twins share the internal organs without fusion, the organs in the side-by-side component are fused with modification of the situs. We postulate sixteen pairs of situs and four manners of division for the explanation of the midline organs and the presence of a dominant co-twin. The splenic locations in a given cardiopulmonary situs are evaluated for the appraisal and applicability of these hypotheses.

A Case of Typical Thoracic Disc Herniation Treated by Transthoracic Transpleural Approach

Herniated thoracic discs are a rare cause of spinal cord compression. The lesions occur predominantly the fourth decade and protrusions between T9 and T12 account for approximated two thirds of cases. The diagnosis is difficult to make clinically due to variable presented symptoms. The myelography and spine CT scan are the most useful diagnostic aids. The authors present a case of typical herniated thoracic disc at T11/T12 who was treated by transthoracic transpleural approach with anterior fusion. The operative result was excellent.