• 제목/요약/키워드: CT-scan

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다발전이성 위장관 간질종양을 동반한 제 1형 신경섬유종증 1예 (A Case of Type 1 Neurofibromatosis Associated with Multiple Metastatic Gastrointestinal Stromal Tumors)

  • 장효진;고성애;정다은;정지윤;구은주;이경희;최준혁;현명수
    • Journal of Yeungnam Medical Science
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    • 제30권2호
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    • pp.105-108
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    • 2013
  • Type 1 neurofibromatosis (von Recklinghausen's disease, NF-1) is an autosomal-dominant neurocutaneous-disorder characterized by systemic cafe'-au-lait spots, multiple cutaneous neurofibromas, axillary or inguinal freckling, and Lisch nodules (pigmented iris hamartomas). Approximately 10-25% of NF1 patients have gastrointestinal neoplasms. Gastrointestinal stromal tumor (GIST) in patients with neurofibromatosis is most commonly found in the small bowel and the stomach, and approximately 60% of such patients have multiple tumors or multiple tumor sites. Although, the increased incidence of GIST in patients with neurofibromatosis is well documented in pathology literature in English, but has rarely been documented in Korea. Here, we report a case of multiple GISTs in a 48-year-old woman accompanied by NF1. She was admitted to Yeung-nam University Hospital with complaints of melena and dyspnea. A contrast-enhanced computed tomography (CT) scan revealed that multiple soft tissue masses were occupying the entire peritoneal cavity. An ultrasonogram- guided biopsy was performed and the tumors were found to have been composed of tumor cells that were positive for c-kit protein. The patient was put on Imatinib mesylate treatment, and further follow-up will be carried out.

Low Lung Cancer Resection Rates in a Tertiary Level Thoracic Center in Nepal - Where Lies Our Problem?

  • Thapa, Bibhusal;Sayami, Prakash
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권1호
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    • pp.175-178
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    • 2014
  • Background: Resection rates of lung cancer are low in general and especially in countries like Nepal. Advanced stage at presentation and poor general condition of the patient are the usual causes. Materials and Methods: In this prospective observational study, one hundred cases of lung cancer who presented at the Thoracic Surgery Unit between October 2011 and October 2012 were included. Results: Those aged in the $6^{th}$ and $7^{th}$ decades together accounted for 72/100 patients. The male to female ratio was 2:1. There was a mean-$29.2{\pm}14.2$ pack yrs smoking history with only five non-smokers. Seventy-six patients presented with locally advanced disease while 21 had metastases. Only three had local disease. The average time between onset of symptoms to first contact with a doctor was $2.3{\pm}5.3$ months (range: 0-35.6 months). Average time between first contact to referral was $50.4{\pm}65.7$ days (range-0-365). Only three patients were resected, one after neo-adjuvant chemotherapy. Advanced disease was the cause of unresectability in 95 cases. One of three patients with local disease had pulmonary functions allowing the warranted resection. $N_2$ disease with $T_{1-3}$ on CT scan was found in 47. Three of these patients underwent mediastinoscopy and all confirmed uninvolved $N_2$. Conclusions: Lung resection rates in our center remain low. Late presentation leading to advanced disease and poor pulmonary reserves preclude resection in most cases. More liberal use of mediastinal staging and better assessment of pulmonary functions may allow us to improve resection rates.

Modeling of Influential Predictors of Gastric Cancer Incidence Rates in Golestan Province, North Iran

  • Behnampour, Nasser;Hajizadeh, Ebrahim;Zayeri, Farid;Semnani, Shahriar
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권3호
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    • pp.1111-1117
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    • 2014
  • Golestan province has a reputation for relatively high incidence rates of gastric cancer in Iran. Along with dietary, lifestyle and environmental influential factors, soil selenium and high levels of pesticide used may exert influence in this region. The present study was designed for modeling the influential predictors on incidence of gastric cancer in Golestan. All registered cases of gastric cancer from March 2009 to March 2010 (49 females and 107 males) were investigated. Data were gathered by both check list and researcher made questionnaire (demographic, clinical and lifestyle characteristics) and analysed using logistic regression. Mean (${\pm}SD$) age at diagnosis was $62.9{\pm}13.8$ years. CIR and ASR of gastric cancer showed 9.16 and 13.9 per 100,000 people, respectively. Based on univariate logistic regression, a history of smoking (OR= 2.076), unwashed hands after defecation (OR= 2.612), history of cancer in relatives (OR= 2.473), history of gastric cancer in first-degree relatives (OR= 2.278), numbers of gastric cancers in first-degree relatives (OR= 2.078), history of X-ray and dye exposure (OR= 2.395), history of CT scan encounter (OR= 2.915), improper food habits (OR= 3.320), specific eating behavior (OR= 0.740), consumption of probable high risk foods (OR= 2.942), charred flesh (OR= 1.945), and animal fat (OR= 2.716) were confirmed as a risk factors. Changes in lifestyle may be expected to increase gastric cancer incidence dramatically in the near future. Therefore, appropriate educational interventions should be designed and implemented by competent authorities.

공혈형 내측 활막추벽 증후군 - 1례 보고 - (Fenestrated Medial Plica Syndrome - A Case Report -)

  • 배대경;전명호;표나실;이정희
    • 대한관절경학회지
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    • 제3권2호
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    • pp.150-154
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    • 1999
  • 공혈형 내측 활막추벽은 내측 활막추벽의 한 형태로 흔하지 않은 것으로 알려져 있으며 그 크기는 다양하여 직경 5mm에서 3-4cm 되는 것도 있다고 보고된다. 그 증상은 비특이적이나 다양한 내측 슬관절 증상을 유발하여 다른 슬관절 내장증의 원인들과 감별 진단이 요구된다. CT scan, MR imaging 등이 진단에 도움이 되지만 결정적인 진단은 관절경술에 의해 이루어지며 보존적 치료를 시행하고 이에 반응하지 않는 경우에 관절경적 절제술을 이용하여 치료를 시행하면 지속적이고 만족스러운 임상 호전을 얻을 수 있다고 보고된다. 본 정형외과 교실에서는 그 빈도가 흔하지 않은 양측 슬관절 공혈형 내측 활막추벽 증후군이 관찰되어 관절경적 절제술을 시행하고 술후 및 외래 추시시 즉각적이며 극적인 임상 호전을 보인 1례가 있어 문헌 고찰과 함께 임상 경험을 보고하는 바이다.

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진성 성조숙증으로 전환된 선천성 부신 과형성증 1례 (A Case of True Precocious Puberty Complicating Congenital Adrenal Hyperplasia)

  • 김수진;이주석;김수영
    • Clinical and Experimental Pediatrics
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    • 제46권4호
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    • pp.400-403
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    • 2003
  • 진단이 지연되었거나 적절하게 치료되지 않은 선천성 부신 과형성증을 가진 남아에서 장기간 고농도의 남성호르몬에 노출될 경우 처음에는 가성 성조숙증이었다가 이후 진성 성조숙증으로 전환될 수 있으므로 선천성 부신 과형성증의 조기진단과 치료가 필요하다. 저자들은 가성 성조숙증에서 진성 성조숙증으로 전환된 선천성 부신 과형성증을 가진 남아에서 hydrocortisone과 GnRH 유도체를 사용하여 큰 부작용 없이 2차 성징의 퇴축을 가져온 1례를 경험하고 문헌고찰과 함께 보고하는 바이다.

뇌지주막하 출혈 후 뇌혈관 연축에 대한 동맥내 Papaverine 주입의 치료효과 (Effect of the Intra-arterial Papaverine Infusion on the Symptomatic Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage)

  • 신준재;이재환;신용삼;허승곤;김동익;이규창
    • Journal of Korean Neurosurgical Society
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    • 제30권3호
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    • pp.325-333
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    • 2001
  • Objective : To clarify the benefits and therapeutic effects of intra-arterial papaverine infusion on the symptomatic cerebral vasospasm, we analyzed the results of treatment in 32 patients retrospectively. Methods : A total of 510 patients underwent surgical clipping or endovascular intra-aneurysmal treatment for ruptured intracranial aneurysm between May, 1996 and June, 1999. The delayed ischemic deficit(DID) was developed in 90 of 510 patients. Of these 90 patients, 32 developed symptomatic vasospasm inspite of using modest "3H therapy". The brain CT scan was taken before the intra-arterial infusion of papaverine. The 32 patients underwent 42 intra-arterial papaverine infusion. The symptomatic vasospasm was divided into three groups : deterioration of mental status(Group 1), appearance of a focal neurologic deficit(Group 2), or both(Group 3). We measured Glasgow Coma Scale(GCS), arterial diameters, and cerebral circulation time(CCT) at the time of pre- and postangioplasty. Results : The number of patients in group 1, 2 and 3 were 26, 7, 9 respectively. Eighteen cases showed improvement of GCS more than 2 scores, 16 more than 1, and 8 showed no change of GCS. Average cerebral circulation time(CCT) was decreased ranging from 0.0%-67.5%, and arterial diameters were increased in 21 cases ranging from 1 to 4 folds. Conclusion : Intra-arterial papaverine infusion seemed to have therapeutic effects on symptomatic vasospasm by improving the neurological signs and increasing the arterial diameter. We suggest that intra-arterial papaverine infusion would be an useful adjunctive therapeutic modality in symptomatic vasospasm.

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골다공증성 척추 압박골절 환자의 경피적 척추성형술에서 Polymethylmethacrylate의 경막 외 유출 (Epidural Leakage of Polymethylmethacrylate Following Percutaneous Vertebroplasty in the Patients with Osteoporotic Vertebral Compression Fractures)

  • 오윤규;류경식;박춘근;강준기
    • Journal of Korean Neurosurgical Society
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    • 제30권3호
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    • pp.319-324
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    • 2001
  • Objectives : The percutaneous vertebroplasty provides a good result in the treatment of osteoporotic vertebral compression fractures. But, the epidural leakage of polymethylmetacrylate(PMMA) after vertebroplasty may decrease the therapeutic effects because of the compression of thecal sac and/or nerve roots. The authors carried out a prospective study to evaluate the causative factors of epidural leakage of PMMA and to assess the influence on the outcome. Methods : This study involved 347 vertebral levels of compression fractures in 159 patients. Among these, the epidural leakages were identified in 92 vertebral levels(26.5%) in 64 patients(40.3%) on post-operative CT scan. Results : The incidence of epidural leakage of PMMA was significantly higher in the level above T7(p=0.001). The large amount of the injected PMMA and the use of an injector also increased the incidence(p=0.03 and p=0.045, respectively). The position of the needle tip in the vertebral body and the pattern of venous drainage did not influence. The immediate post-operative visual analogue scale(VAS) scores and facial scales(FS) were higher in the patients with epidural leakage(p=0.009). But there were no significant differences between the two groups after three months of operation(p=0.541). Conclusions : The incidence of epidural leakage of PMMA after percutaneous vertebroplasty appears to have relationship with the amount of PMMA and the levels injected. The epidural leakage of PMMA reduced the immediate therapeutic effects of vertebroplasty, but did not influence the late outcome. However, the epidural leakage should be avoided because of its potential neurological complications.

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Histomorphometric Analysis of the Spine and Femur in Ovariectomized Rats Using Micro-Computed Tomographic Scan

  • Shin, Yong-Hwan;Cho, Dae-Chul;Yu, Song-Hee;Kim, Kyoung-Tae;Cho, Hee-Jung;Sung, Joo-Kyung
    • Journal of Korean Neurosurgical Society
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    • 제52권1호
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    • pp.1-6
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    • 2012
  • Objective : The purpose of this study was to evaluate the different patterns of bone loss between the lumbar spine and the femur after ovariectomy in rats. Methods : Twenty-four female Sprague-Dawley rats underwent a sham operation (the sham group) or bilateral ovariectomy (the ovariectomized group). Four and eight weeks after operation, six rats from each of the two groups were euthanized. Serum biochemical markers of bone turnover including osteocalcin and alkaline phosphatase (ALP), which are sensitive biochemical markers of bone formation, and the telopeptide fragment of type I collagen C-terminus (CTX), which is a sensitive biochemical marker of bone resorption, were analyzed. Bone histomorphometric parameters of the 4th lumbar vertebrae and femur were determined by micro-computed tomography. Results : Ovariectomized rats were found to have higher osteocalcin, ALP and CTX levels than sham controls. Additionally, 8 weeks after ovariectomy in the OVX group, serum levels of osteocalcin, ALP and CTX were significantly higher than those of 4 weeks after ovariectomy. Bone loss after ovariectomy was more extensive in the 4th lumbar spine compared to the femur. Bone loss in the 4th lumbar spine was mainly caused by trabecular thinning, but in the femur, it was mainly caused by trabecular elimination. Conclusion : The present study demonstrates different patterns of bone loss between the 4th lumbar spine and the femur in ovariectomized rats. Therefore, when considering animal models of osteoporosis, it is important that bone sites should be taken into account.

입체각 측정을 통한 대퇴골두에 대한 관골구 coverage 측정 (The solid angle estimation of acetabular coverage of the femoral head using 3D method)

  • 최교환;김만찬;임제탁;김선일
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1997년도 춘계학술대회
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    • pp.123-126
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    • 1997
  • We present a method for the estimation of 3D solid angle assessment of the acetabular coverage of the femoral head in 3D space. At first, femoral head and acetabulum is segmented from the original CT scan images. The slice thickness is 1.5mm and the number of slices is usually 30-40 to cover the entire acetabulum. The superior half of the femoral head is modeled as part of a sphere. Thus, the axial cross sections of the upper half of the femoral head are also modeled as circles. A set of points from each outline image of femoral head is fitted recursively into a circle by minimizing root-mean-square (RMS) error. With these fitted circles, a center point of the femoral head model is evaluated. This is a reference point for calculating the solid angle of the acetabular inner surface. Next, the tangent lines connecting from a set of points of the acetabular edge to the center of the fitted sphere are obtained. The lines pass through the unit sphere whose center is the same as that of the femoral head. With the points on the unit sphere, we calculate area and estimate the solid angle. Based on this solid angle, the deformity of the acetabulum is analyzed. In case of normal subject, the solid angle is about 4.3 (rad) and acetabular coverage is 68%.

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듀얼센서 기반 X-선 검색영상 스테레오 가시화 연구 (A Study on Stereo Visualization of the X-ray Scanned Image Based on Dual-line Sensors)

  • 이남호;황영관;박종원;임용곤
    • 한국정보통신학회논문지
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    • 제14권9호
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    • pp.2083-2090
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    • 2010
  • 본 논문에서는 고속 이동 컨테이너 화물을 효율적으로 검색하기 위한 스테레오 방사선 영상 기반 3차원 형상화 연구에 관하여 기술하였다. 스테레오 방사선 영상은 X-선 발생장치, 선형 방사선 센서 그리고 이동 스테이지로 구성한 일련의 장치로부터 실물을 대상으로 획득하였다. 두 개의 방사선 센서는 검색 대상체의 정류된 X-선 영상을 얻도록 설계 및 제작되었다. 스테레오 X-선 영상을 이용하여 두 영상간의 대응점을 찾는 매칭 알고리즘을 구현하고, 대상체의 실제 3차원 형상을 복원과정을 연구하였다. 대상체는 컨테이너 화물을 모사하기 위해 평형 철재 상자 내부에 넣은 다음 시험하였다. 3가지 대상체에 대해 스캔시험과 3차원 복원과정을 차례로 진행하였으며, 방사선 영상의 정보부족으로 인한 한계를 극복하기 위해 에지정보를 기반으로한 영상복원을 시도하였다. 시험결과는 제안한 기술이 컨테이너 화물 검색에서 보다 효율적인 정보를 제공할 수 있음을 확인시켜 주었다.