Gisma Ahmed Madani;Wael Amin Nasr El-Din;Asmaa S. Essawy;Khamrunissa Hussain;Islam Omar Abdel Fattah
Anatomy and Cell Biology
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v.55
no.4
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pp.423-432
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2022
The nasal septum is a crucial supporting factor for the nasal cavity and may develop several anatomical variants including septal deviation, spur and pneumatization. These variants could be associated with a higher incidence of sinusitis due to structural and functional alterations. So, the aim of this study was to assess the prevalence of nasal septal deviation (NSD), nasal septal spur (NSS) and nasal septal pneumatization (NSP) among the Saudi adult population and their links with the incidence of sinusitis by using computed tomography (CT). A retrospective study was achieved over a twenty-two months period on 681 adult Saudi subjects (420 males and 261 females) aged 20 years or older, referred for coronal CT evaluation of the paranasal sinuses. NSD and NSS were significantly more prevalent in males than females (80.0% vs. 67.4% respectively for NSD, and 34.5% vs. 24.9% respectively for NSS), while there was no statistical difference in frequency of NSP regarding gender (P=0.670). The incidence of sinusitis was significantly higher in presence of NSD and/or NSS (P<0.001 for both). On the contrary, NSP was not associated with a significant increase in the prevalence of sinusitis (P=0.131). In conclusion, NSD and NSS are more prevalent in males than females among the Saudi population with no statistical difference between both genders regarding the presence of septal pneumatization. Furthermore, sinusitis is more prevalent with the occurrence of NSD and NSS, and not related to the incidence of NSP.
Purpose: Hepatic resection is arguably the preferred treatment for huge hepatocellular carcinoma (H-HCC). Estimating the remnant liver volume is therefore essential. This study aimed to evaluate the feasibility of using computer-assisted volumetric analysis for this purpose. Methods: The study involved 40 patients with H-HCC. Laboratory examinations were conducted, and a contrast CT-scan revealed that 30 cases out of the participating 40 had single-lesion tumors. The remaining 10 had less than three satellite tumors. With the consensus of the team, two physicians conducted computer-assisted 3D segmentation of the liver, tumor, and vessels in each case. Volume was automatically computed from each segmented/labeled anatomical field. To estimate the resection volume, virtual lobectomy was applied to the main tumor. A margin greater than 1 cm was applied to the satellite tumors. Resectability was predicted by computing a ratio of functional liver resection (R) as (Vresected-Vtumor)/(Vtotal-Vtumor) x 100%, applying a threshold of 50% and 60% for cirrhotic and non-cirrhotic cases, respectively. This estimation was then compared with surgical findings. Results: Out of the 22 patients who had undergone hepatectomies, only one had an R that exceeded the threshold. Among the remaining 18 patients with non-resectable H-HCC, 12 had Rs that exceeded the specified ratio and the remaining 6 had Rs that were < 50%. Four of the patients who had Rs less than 50% underwent incomplete surgery due to operative findings of more extensive satellite tumors, vascular invasion, or metastasis. The other two cases did not undergo surgery because of the high risk involved in removing the tumor. Overall, the ratio of functional liver resection for estimating resectability correlated well with the other surgical findings. Conclusion: Efficient pre-operative resectability assessment of H-HCC using computer-assisted volumetric analysis is feasible.
Jeong-Won Shin;Jiwon Park;Su-Hyun Chin;Kwan-Il Kim;Hee-Jae Jung;Beom-Joon Lee
The Journal of Internal Korean Medicine
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v.44
no.6
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pp.1294-1317
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2023
Background: Post-COVID-19 pulmonary fibrosis (PCPF) is a common complication in severe COVID-19 cases, often associated with acute respiratory distress syndrome or mechanical ventilation. Patients with PCPF frequently experience a decline in their quality of life due to persistent COVID-19 sequelae, including cough and chest pain. However, there is currently no established standard treatment, and the efficacy of existing medications remains uncertain. Case Report: A 65-year-old female patient presenting with cough, dyspnea, chest pain, and fatigue due to PCPF received Korean medicine treatment for 25 days. Symptom evaluation utilized the modified Medical Research Council scale, the Leicester Cough Questionnaire, and the Numeral Rating Scale. Quality of life and functional status were assessed using the Post-COVID-19 Functional Status and the EuroQol 5-Dimensional 5-Level. The extent of pulmonary fibrosis was assessed by comparing chest computed tomography (chest CT) scans before and after hospitalization. Following treatment, the patient demonstrated clinically meaningful improvement in clinical symptoms, enhanced quality of life, and decreased fibrotic lesions on CT scans. Conclusion: This case report suggests that Korean medicine treatment may be effective in improving clinical symptoms, such as cough and dyspnea caused by PCPF, while also enhancing post-COVID-19 quality of life and ameliorating pulmonary fibrotic lesions.
Cerebral vasoreactivity is an index of autoregulation of cerebral perfusion, and can be measured using functional images such as Xe CT, SPECT and PET in reponse to hypercapneic stimulus. In order to measure cerebral $CO_2$ vasoreactivity in routine TCD study conveniently and reliably, we devised a method of rebreathing into closed volume of reservoir bag as a hypercapneic stimulus, and applied it to 44 healthy volunteers. As a hypercapneic stimulus, we applied fitting mask connected with closed reservoir bag for about 90 seconds, and mean blood flow velocity(MBFV) and pulsatility index(PI) were evaluated at proximal middle cerebral arteries(MCA) of 50-55 mm depth, before and after the hypercapneic stimulus. Age affected the MFV and PI value showed significant and the MFV was 56.45(SD=9.75)cm/sec, while PI was 0.406(SD=0.089). As age increases the flow velocity decreased significantly whereas PI value increased(P<0.05). The vasoreactvity significantly decreased with age(P<0.05). The decrease of cerebral blood flow quantity and cerebral blood flow velocity is not only because of increase of diameter of cerebrovascular resulting from aging, but the resistance increase of small blood vessel resulting from the increase of PI & RI value is regarded. We suppose that the rebreathing method is a reliable and convenient technique as a hypercapneic stimulus in determining cerebral $CO_2$ vasoreactivity. The rebreathing method could be non-invasive and useful methods in estimation of the cerebrovascular reactivity and could be applied to the basal and follow-up evaluation of the cerebrovascular reserve of the ischemic stroke patients.
Choi, Hwan Jun;Lee, Yong Seok;Choi, Chang Yong;Tark, Min Sung
Archives of Plastic Surgery
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v.36
no.2
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pp.188-193
/
2009
Purpose: Several authors reported about the post - traumatic nasal aesthetic complications. However, the study for functional or intra - nasal complications has been reported not enough. The aim of this study is to observe the incidence of intranasal synechia. Methods: We reviewed the data from 401 consecutive patients with nasal bone fracture from september 2006 to December 2007. We enforced evaluation with preoperative CT in all patients but postoperative CT within complicated patients. We classified the nasal bone fracture according to the anatomy and severity of fracture. Type I is nasal tip fracture(15%, n = 59), Type II is simple lateral without septal injury(38%, n = 152), Type III is simple lateral with septal injury(23%, n = 92), Type IV is closed comminuted(20%, n = 82), Type V is open comminuted or complicated(4%, n = 16). We studied 98 patients with nasal bone fracture who had postoperative symptoms or undergone postoperative endoscopic evaluation. And then we evaluated the postoperative endoscopic finding and nasal synechal formation after operation. Results: The incidence of intranasal synechiae was 15%(n = 62). According to the endoscopic findings, the incidence of intranasal synechiae was 10%(n = 6) in Type I, 8%(n = 12) in Type II, 16%(n = 15) in Type III, 24%(n = 20) in Type IV, and 56%(n = 9) in Type V. Additionally, the incidence of subjective nasal obstruction and olfactory dysfunction is 18%(n = 72) and 13%(n = 51). But the incidence of symptomatic synechiae of nasal obstruction and olfactory dysfunction is 92%(57/62) and 55%(34/62). Conclusion: We identified relatively high prevalence of nasal obstruction and olfactory dysfunction in nasal synechiae. Based on the results of this study, intranasal synechiae really caused airway obstruction(92%). Our data showed significant relationship between intranasal synechiae and severity of the fracture, because of increasing mucosal handling and destructive closed reductional procedures. First of all, education of delicate procedure regarding this subject should be empathized accordingly.
Cha, Youn-Soo;Yang, Ji-Ae;Back, Hyang-Im;Kim, Soo-Ran;Kim, Min-Gul;Jung, Su-Jin;Song, Won O;Chae, Soo-Wan
Nutrition Research and Practice
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v.6
no.6
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pp.520-526
/
2012
Various forms of fermented soybean products are well documented for their health benefits. The efficacy of anti-obesogenic effect of Doenjang, one of the most commonly used seasonings in Korean cuisine, has been reported only in animal models; thus, an evaluation of Doenjang needs to be conducted in human studies. We aimed to test the hypothesis that Doenjang supplementation reduces body weight and changes body composition in overweight adults. A total of 51 overweight adults participated in this study. A group of males with BMI ${\geq}23kg/m^2$ and waist to hip ratio (WHR) ${\geq}$ 0.90, and a group of females with BMI ${\geq}23kg/m^2$ and WHR ${\geq}$ 0.85 were randomly assigned to either a Doenjang supplement (9.9 g dry/day) group or a placebo group for a 12-week randomized, double-blind and placebo-controlled study. Anthropometric parameters, abdominal fat distribution by computerized tomography (CT) and blood components were measured before and after the intervention period. After the 12-week study, the Doenjang supplementation group had significant reductions in body weight (kg), body fat mass (kg) and body fat (%) compared to the placebo group, the supplementation of Doenjang resulted in a significant reduction in visceral fat ($cm^2$), although no changes were observed in total and subcutaneous fat are as ($cm^2$), serum lipid profiles and dietary intakes. The present study demonstrated that daily supplementation of 9.9 g dry/day of Doenjang for 12 weeks reduces body weight and visceral fat in overweight adults.
Objective : The purpose of this study was to suggest that computed tomography angiography (CTA) is valuable as the only preliminary examination for mechanical thrombectomy (MT). MT after single examination of CTA including noncontrast computed tomography (NCCT) and maximum intensity projection (MIP) improves door-to-puncture time as well as results in favorable outcomes. Methods : A total of 157 patients who underwent MT at Dong Kang Medical Center from April 2015 to March 2019 were divided into two groups based on the examination performed prior to MT : CTA group who underwent CTA with NCCT and MIP, and NCCT+magnetic resonance image (MRi) group who underwent MRI including perfusion images after NCCT. In the two groups, time to CTA imaging or NCCT+MRi imaging after symptom onset, and time to arterial puncture and reperfusion were characterized as time-related outcomes. The evaluation of vascular recanalization after MT was defined as a modified thrombolysis in cerebral infarction (mTICI) scale. National Institutes of Health Stroke Scale (NIHSS) was assessed at the time of the visit to the emergency room and modified Rankin Scale (mRS) was assessed after 90 days. Results : Typically, there were 34 patients in the CTA group and 33 patients in the NCCT+MRi group. A significantly shorter delay for door-to-puncture time was observed (mean, 86±22.1 vs. 176±47.5 minutes; <0.01). Also, a significantly shorter door-to-imege time in the CTA group was observed (mean, 13±6.8 vs. 93±30.8 minutes; p<0.01). Moreover, a significantly shorter onset-to-puncture time was observed (mean, 195±128.0 vs. 314±157.6 minutes; p<0.01). Reperfusion result of mTICI ≥2b was 100% (34/34) in the CTA group and 94% (31/33) in the NCCT+MRi group, and mTICI 3 in 74% (25/34) in the CTA group and 73% (24/33) in the NCCT+MRi group. Favorable functional outcomes (mRS score ≤2 at 90 days) were 68% (23/34) in the CTA group and 60% (20/33) in the NCCT+MRi group. Conclusion : A single-phase CTA including NCCT and MIP images was performed as a single preliminary examination, which led to a reduction in the time of the procedure and resulted in good results of prognosis. Consequently, it is concluded that this method is of sufficient value as the only preliminary examination for decision making.
Drug eruption is a cutaneous reaction caused by various drugs. It is a very common drug induced adverse reaction. Contrast media induced drug eruption is rare. But approximately 10% of people injected with contrast media experience adverse reaction, and drug eruption accounts for more than 40% of all adverse reactions. We report a case of mild drug eruption and its treatment process based on korean traditional medicine. The patient is a 50 years old female diagnosed with functional dyspepsia. The patient had gastric discomfort and alternation between diarrhea and constipation. All symptoms showed nearly complete remission with continued korean traditional medical treatment. The patient had been injected with contrast media for Computed tomography(CT) evaluation of her breast cancer history. Rashes appeared on back and abdomen, and urticaria and pruritus appeared on the patient's finger 1 day after injection. We prescribed Goreisan(TSUMURA CO &, TJ-17) and acupuncture on Quchi(LI11), Zusanli(ST36), Yangxi(LI5), Yanggu(SI5). Consequently, the drug eruption showed remarkable improvement. So the author reports korean traditional medicine is effective complementary treatment for drug eruption.
Orofacial pain and limited range of mouth opening as symptoms of temporomandibular disorder are mainly triggered by the structural and/or functional changes of temporomandibular joint and related structure itself. But careful diagnostic evaluation should be needed because they may be occurred by another pathologic conditions such as neoplasm in head and neck region. If there would be atypical pain characteristics or clinical features, systemic comorbid symptoms, or poor response to treatment, advanced imaging modalities such as CT or MRI will be mandatory for differential diagnosis. We experienced the case which was diagnosed as nasopharyngeal cancer mimicking temporomandibular disorder, and reviewed clinical considerations for proper differential diagnosis.
The economic feasibility analysis including benefit-cost ratio and internal rate of return of a land consolidation and on-farm development project was mainly depended upon the direct benefits and costs arising during project life. Therefore the projects were neglected in allocating the government's financial funds and loans on account of the low economic rate of return of the project. Accordingly the extended benefit-cost analysis method should be introduced and adapted to cover not only the benefit s such as non-market values of environmental and food security fun ct ions of the project but also market values of the project outputs. The main purposes of this study are (1) to prepare a guide line for economic feasibility analysis based on the IBRD and ADB guidelines, (2) to estimate the benefits from productivity increase, labor saving, savings of O&M cost of farm mechanization and project facilities, savings of farmer's burden for their public health, increasing environmental and public functional value of paddy fields, improving food security condition and formation of peaceful and uncontroversial rural society by implementing the land consolidation and on-farm development, (3) to introduce the newly adapted analytical method as the extended benefit cost analysis which could make possible to be included the values of non-market goods such as the food security and the environmental public function of paddy fields. To carry out this study, the existing publications on the guidelines for economic agricultural projects were reviewed and consultation was made with a For the post evaluation study of the land consolidation and on-farm development project, field survey in Jigok and other comparative area were made to get available information. According to the project completion report, Jigok land consolidation and on-farm development project has 55ha of benefit area out of 69ha of gross area. The project was started in November 11th, 2000 and completed october 30th, 2001. The total project costs were amounted to 2,548 million won and the annual project benefits were estimated at 335million won evaluated by domestic market prices. The ERR(Economic Rate of Return) and SRR(Social Rate of Return) of the project based on the shadow pricing system were estimated at 4.4% and 16% respectively. On the other hand, the ERR and SRR based on the domestic market value system were amounted to 6.37% and 14.62%. In conclusion, Korean land consolidation and on-farm development projects have not carried out from the view point of economic rate of return under shadow pricing system but from the view point of domestic pricing system. For the future feasibility studies on land consolidation projects have to be carried out including the non-market values as environmental and food security function of the projects.
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