• 제목/요약/키워드: Head and Neck

검색결과 4,544건 처리시간 0.026초

Towards Routine Clinical Use of Radial Stack-of-Stars 3D Gradient-Echo Sequences for Reducing Motion Sensitivity

  • Block, Kai Tobias;Chandarana, Hersh;Milla, Sarah;Bruno, Mary;Mulholland, Tom;Fatterpekar, Girish;Hagiwara, Mari;Grimm, Robert;Geppert, Christian;Kiefer, Berthold;Sodickson, Daniel K.
    • Investigative Magnetic Resonance Imaging
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    • 제18권2호
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    • pp.87-106
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    • 2014
  • Purpose : To describe how a robust implementation of a radial 3D gradient-echo sequence with stack-of-stars sampling can be achieved, to review the imaging properties of radial acquisitions, and to share the experience from more than 5000 clinical patient scans. Materials and Methods: A radial stack-of-stars sequence was implemented and installed on 9 clinical MR systems operating at 1.5 and 3 Tesla. Protocols were designed for various applications in which motion artifacts frequently pose a problem with conventional Cartesian techniques. Radial scans were added to routine examinations without selection of specific patient cohorts. Results: Radial acquisitions show significantly lower sensitivity to motion and allow examinations during free breathing. Elimination of breath-holding reduces failure rates for non-compliant patients and enables imaging at higher resolution. Residual artifacts appear as streaks, which are easy to identify and rarely obscure diagnostic information. The improved robustness comes at the expense of longer scan durations, the requirement for fat suppression, and the nonexistence of a time-to-center value. Care needs to be taken during the configuration of receive coils. Conclusion: Routine clinical use of radial stack-of-stars sequences is feasible with current MR systems and may serve as substitute for conventional fat-suppressed T1-weighted protocols in applications where motion is likely to degrade the image quality.

동의보감(東醫寶鑑)에 따른 편(偏), 담궐(痰厥) 몇 기궐두통(氣厥頭痛) 환자의 임상적 고찰 (A Clinical Study of Patients with Headache Founded on DongEuiBoGam)

  • 김지윤;홍현우;김재연;김기탁;허태율;박동일;감철우
    • 대한한방내과학회지
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    • 제26권4호
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    • pp.806-819
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    • 2005
  • Objective : The purpose of this study is to investigate clinical characteristics and remedial value oriental medical therapy for sufferers of severe headache. Methods : On the authority of DongEuiBoCam, patients were classified into three groups: migraine, qi-syncope headache and phlegm-headache. All patients wert treated with acupuncture therapy and herb medicines. After that inquiry was made into the extent of improvement of headache. Results : 1. In accordance with the statistics, 56 cases(50.5%) had phlegm-syncope headache, 28 cases(25.2%) had qi-syncope headache and 27 cases(24.3%) had migraine. 2. The ratio between males and females was about 1:4. Most patients were in their forties. 3. 12 cases(31.6%) with migraine had pain only on the right side of the head, 20 cases(26.3%) with phlegm-syncope and 17 cases(45.6%) with qi-syncope headache suffered from the frontal lobe headache. 4. 8 cases(29.6%) with migraine had been suffering for a week or less, 12 cases(21.4%) with phlegm-syncope headache had been suffering for over six months and under one year and 6 cases(21.4%) with qi-syncupe headache had suffered over one year and under five. 5. Overwork and stress was deemed the main cause of migraine. Phlegm-syncope headache was also attributed to stress and tense situations. Qi-syncope headache was believed to be variously caused by traffic accident, noise, blood pressure and other reasons. 6. 46 cases(30%) felt dull headache and 32 cases(20.9%) felt dizzy. The common associated symptoms of migraine and qi-syncope headache included back, neck and shoulder pain and other pains. Dizziness was an especially prevalent symptom of phlegm-syncope headache. 7. After the oriental medical therapy, 12 cases(10.8%) almost entirely recovered, 50 cases(45%) were in about half as much pain, 45 cases(40.5%) improved little and 4 cases(3.6%) felt no improvement. Conclusions : The results support a role for oriental medical therapy in treatment of headache.

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부분층 피부이식으로 전판상화된 전완유리피판을 이용한 경구개 결손의 재건 (Reconstruction of Hard Palatal Defect using Staged Operation of the Prelaminated Radial Forearm Free Flap)

  • 최의철;김준혁;남두현;이영만;탁민성
    • 대한두개안면성형외과학회지
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    • 제11권1호
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    • pp.53-57
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    • 2010
  • 연부조직만으로 경구개를 재건하는데 있어서는 환자군을 적절히 선택하는 것이 중요하며 골재건이 필요하지 않은 Okay 분류 Ia와 Ib가 주요한 적응증이 된다. 하악이나 구강저부 결손을 재건하는 것과는 다르게 경구개 결손은 구강과 비강 점막층을 동시에 수복할 수 있는 피판이 이상적이다. 이중 저자들은 전완유리피판에 전상판화 방법을 좀 더 안정적으로 시행, 경구개 전층을 성공적으로 재건하였으며, 특히 저작과 연하 등 기능적 측면뿐 아니라 경구개 및 비강의 점막을 함께 복원할 수 있는 해부학적인 장점이 있는 피판임을 확인하여 문헌고찰과 함께 보고하는 바이다.

Complex oncologic resection and reconstruction of the scalp: Predictors of morbidity and mortality

  • Tecce, Michael G.;Othman, Sammy;Mauch, Jaclyn T.;Nathan, Shelby;Tilahun, Estifanos;Broach, Robyn B.;Azoury, Said C.;Kovach, Stephen J.
    • 대한두개안면성형외과학회지
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    • 제21권4호
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    • pp.229-236
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    • 2020
  • Background: Oncologic resection of the scalp confers several obstacles to the reconstructive surgeon dependent upon patient-specific and wound-specific factors. We aim to describe our experiences with various reconstructive methods, and delineate risk factors for coverage failure and complications in the setting of scalp reconstruction. Methods: A retrospective chart review was conducted, examining patients who underwent resection of fungating scalp tumors with subsequent soft-tissue reconstruction from 2003 to 2019. Patient demographics, wound and oncologic characteristics, treatment modalities, and outcomes were recorded and analyzed. Results: A total of 189 patients were appropriate for inclusion, undergoing a range of reconstructive methods from skin grafting to free flaps. Thirty-three patients (17.5%) underwent preoperative radiation. In all, 48 patients (25.4%) suffered wound site complications, 25 (13.2%) underwent reoperation, and 47 (24.9%) suffered from mortality. Preoperative radiation therapy was an independent risk factor for wound complications (odds ratio [OR], 2.85; 95% confidence interval [CI], 1.1-7.3; p=0.028) and reoperations (OR, 4.45; 95% CI, 1.5-13.2; p=0.007). Similarly, the presence of an underlying titanium mesh was an independent predictor of wound complications (OR, 2.49; 95% CI, 1.1-5.6; p=0.029) and reoperations (OR, 3.40; 95% CI, 1.2-9.7; p=0.020). Both immunosuppressed status (OR, 2.88; 95% CI, 1.2-7.1; p=0.021) and preoperative radiation therapy (OR, 3.34; 95% CI, 1.2-9.7; p=0.022) were risk factors for mortality. Conclusion: Both preoperative radiation and the presence of underlying titanium mesh are independent risk factors for wound site complications and increased reoperation rates following oncologic resection and reconstruction of the scalp. Additionally, preoperative radiation, along with an immunosuppressed state, may predict patient mortality following scalp resection and reconstruction.

MTT법을 이용한 사람 골육종과 상피암 세포주들에 대한 항암제 감수성 검사 (CHEMOSENSITIVITY TEST OF HUMAN OSTEOSARCOMA AND EPIDERMOID CARCINOMAS USING MTT ASSAY)

  • 박승오;신효근;김오환
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제13권4호
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    • pp.391-404
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    • 1991
  • Three anticncer agents which are different in time or dosage dependence as well as in phase specificity, namely mitomycin and adriamycin from natural products, and widely different cancer cell lines_Four epidermoid carcinomas originated from larynx, cervix, skin and gut were used toghether with one osteosarcoma as the target cell of single and combined administration of anticancer drugs. Semiautomated tetrazolium dye assay(MTT) appears to offer an attractive option for chemosensitivity of head and neck cancers since it is a simple, valid and inexpensive method of assessing chemosensitivity for large samples in a short time. The results obtained form this study were as follows. 1. Good correlations were obtained with the results of the MTT test and those of $^3H$ thymidine uptake assay. 2. $LD_{50}$ values of HIST and St.Ca. which showed relatively high doubling time on adriamycin were $30{\mu}g/ml$ and $15{\mu}g/ml$ while those of HeLa, Hep-2 and KHOS/NP were $2.1{\mu}g/ml$, $4.8{\mu}g/ml$, and $6.8{\mu}g/ml$ respectively. 3. The $LD_{50}$ value of 5-FU on five cancer cells were very high ranging from 15mg/ml to almost indefinite number, which means 5-FU is very resistant to epidermoid carcinomas or osteosarcoma examined in this study. 4. Mitomycin was relatively effective showing 80% cancer killing effect on HeLa, 70% on St. Ca. and 50% on Hep-2 at the high concentrations used. 5. Adriamycin was the most effective showing 90% cancer cell killing effect on KHOS/NP, 98% on HeLa, 80% both on Hep-2 and St. Ca. The least susceptible cancer cells toward adriamycin was HIST having only 55% cell killing effect at the high cincentration. 6. Combined therapy of adriamycin and 5-FU was more effective than single administration in all the cases examined. Most effective synergism was observed on St. Ca. at the low concentration, showing 21 times higher than each single administration.

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실크필름에 배양한 망막색소상피세포의 거동 (Behavior of Retinal Pigment Epithelial Cells Cultured on Silk Films)

  • 이소진;김혜윤;김슬지;양재원;이선의;박찬흠;주천기;강길선
    • 폴리머
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    • 제38권3호
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    • pp.364-370
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    • 2014
  • 망막색소상피(RPE)는 건강한 망막을 유지하는데 중요한 역할을 하고 RPE의 퇴화는 많은 망막질병을 유발한다. RPE 이식은 최근 망막 퇴화에 대한 가능성 있는 치료법으로 제시되고 있다. RPE 세포를 안전하게 이식하기 위해서는 지지체가 필요하므로 독특한 기계적 성질과 생체적합성을 갖는 실크를 사용하여 필름을 제조하였다. 실크필름의 FTIR, 접촉각 및 생분해성을 측정한 후, RPE 세포를 실크필름에 파종하여 그 영향을 확인하였다. MTT 분석, SEM, 면역형광염색, RT-PCR을 통해 세포의 부착, 생존도, 형태유지, 특이적 mRNA의 발현을 분석하였다. 본 연구에서는, 실크필름에 배양한 RPE 세포의 부착, 증식 및 표현형 유지가 뛰어남을 확인함으로써 실크필름의 망막 재생을 위한 조직 공학적 지지체로의 응용 가능성을 제시했다.

하이드록시아파타이트/락타이드 글리콜라이드 공중합체 지지체 조성에 따른 염증 완화 효과 (Inflammatory Responses to Hydroxyapatite/Poly(lactic-co-glycolic acid) Scaffolds with Variation of Compositions)

  • 장지은;김혜민;김형석;전대연;박찬흠;권순용;정진화;강길선
    • 폴리머
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    • 제38권2호
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    • pp.156-163
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    • 2014
  • 하이드록시아파타이트는 골 전도가 우수하고 생체 적합성이 우수하며 염증 반응을 일으키지 않아 임상에서 골이식재로 널리 사용되고 있다. 본 연구에서는 하이드록시아파타이트를 함유한 poly(lactic-co-glycolic acid) (PLGA) 지지체를 제조하였으며 생체 내/외의 실험을 통하여 골 이식재로서의 응용가능성을 평가하였다. 하이드록시아파타이트/PLGA 지지체는 0, 10, 20, 40 및 60 wt%의 함량으로 제조하였다. 기계적 특성을 알아보기 위하여 압축강도, SEM, FTIR을 측정하였으며 MTT, RT-PCR, FACS, 조직학적 염색(H&E, ED-1)을 실시하였다. 그 결과 하이드록시아파타이트를 함유한 PLGA 지지체에서 염증 반응이 감소하는 것을 확인할 수 있었으며 골 이식재로서의 가능성을 보여주었다.

Facial Nerve Repair following Acute Nerve Injury

  • Fliss, Ehud;Yanko, Ravit;Zaretski, Arik;Tulchinsky, Roei;Arad, Ehud;Kedar, Daniel J.;Fliss, Dan M.;Gur, Eyal
    • Archives of Plastic Surgery
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    • 제49권4호
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    • pp.501-509
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    • 2022
  • Background Acute facial nerve iatrogenic or traumatic injury warrants rapid management with the goal of reestablishing nerve continuity within 72 hours. However, reconstructive efforts should be performed up to 12 months from the time of injury since facial musculature may still be viable and thus facial tone and function may be salvaged. Methods Data of all patients who underwent facial nerve repair following iatrogenic or traumatic injury were retrospectively collected and assessed. Paralysis etiology, demographics, operative data, postoperative course, and outcome were examined. Results Twenty patients underwent facial nerve repair during the years 2004 to 2019. Data were available for 16 of them. Iatrogenic injury was the common category (n = 13, 81%) with parotidectomy due to primary parotid gland malignancy being the common surgery (n = 7, 44%). Nerve repair was most commonly performed during the first 72 hours of injury (n = 12, 75%) and most of the patients underwent nerve graft repair (n = 15, 94%). Outcome was available for 12 patients, all of which remained with some degree of facial paresis. Six patients suffered from complete facial paralysis (50%) and three underwent secondary facial reanimation (25%). There were no major operative or postoperative complications. Conclusion Iatrogenic and traumatic facial nerve injuries are common etiologies of acquired facial paralysis. In such cases, immediate repair should be performed. For patients presenting with facial paralysis following previous surgery or trauma, nerve repair should be considered up to at least 6 months of injury. Longstanding paralysis is best treated with standard facial reanimation procedures.

치과내원 환자의 이용행태 및 공포와 구강악안면 통증 (Patients who Visit to Dental Clinic Utilization Behavior, Dental Fear and Oral and Maxillofacial Pain)

  • 정명희;전성희
    • 치위생과학회지
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    • 제9권3호
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    • pp.361-367
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    • 2009
  • 본 연구는 치과내원환자 334명을 대상으로 치과공포 및 행태에 따른 구강악안면증상을 알아보고자 연구를 시행하였다. 성별과 연령, 치과이용행태 등의 일반적 특성 5문항, 20개문항의 DFS, 스트레스 증상설문지 (Stress Symptom Questionnaire) 20문항을 이용하여 설문조사한 후 얻어진 자료들을 SPSS 12.0을 사용하여 검정하였다. 분석한 결과는 다음과 같다. 1. 여성이 남성보다 공포가 높았고, 연령은 30세 이상에서 공포가 높게 나타났으며, 통계적으로 유의하게 나타났다(p<0.05). 2. 치과진료회피반응, 생리적 반응, 공포유발자극요인 중에서 치료자극반응이 가장 높았으며, 성별과 비교해서는 여성이 모두 높은 점수를 보였으며, 통계적으로 매우 유의하였다(p<0.01). 3. 구강악안면증상부위에 따른 반응정도는 기타 구강외 증상이 62.9%로 가장 높았으며, 항목으로는 뒷머리가 당기거나 목덜미가 뻣뻣하다가 가장 높은 것으로 나타났다. 4. 일반적 특성에 따른 구강악안면증상은 성별에서 혀에서만 유의하였고(p<0.05), 연령은 30세 이상에서 입술이나 볼안쪽, 기타 구강외증상이 더 높게 나타났다. 5. 정기검진을 하는 경우, 스켈링경험이 있는 경우, 마취경험이 있는 경우, 내원횟수가 많은 경우 구강악안면증상이 높았으며, 통계적으로는 스켈링경험이 있는 경우와 내원횟수가 많은 경우가 혀에서만 유의하게 나타났다(p<0.05). 6. 공포정도에 따른 구강악안면증상은 고공포 그룹에서 각 부위별 구강악안면증상이 높게 나타났고, 통계적으로도 모두 유의하게 나타났으며, 공포와 각 구강악안면증상 간에 양의 상관관계를 나타내었으며 통계적으로도 유의하였다(p<0.05).

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제주 지역 간호사의 구강 악안면 영역 손상에 대한 응급 처치 인식도 (Cognition of registered nurse on emergency treatment for oral and maxillofacial injury in Jeju province)

  • 이병진;송효정;임길채;감세훈;김성준
    • 대한치과의사협회지
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    • 제50권12호
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    • pp.763-770
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    • 2012
  • The purposes of this work were to assess the cognition of the registered nurse(RN) on oral and maxillofacial emergency treatment and to compare cognition of the RN with that of the 119 emergency medical technician(EMT). 450 RNs who were working at each of secondary hospitals in Jeju province had responded to the questionnaire. Independent sample t-test and chi-square test were used to assess the state of RN on dental emergency treatment and to compare RN with EMT. The question 'education time on dentistry in formal education' that marked '0 hour' and '1-3 hours' were 73.3% and 20.0%, respectively. The question 'refresher training class on dentistry' that marked '0 hour' and '1-3 hours' were 92.9% and 6.7%, aggregately 99.6%. The results showed low score in the question 'reduction of temporo-mandibular joint(TMJ)'($1.67{\pm}0.857$), 'fixation of dislocated TMJ'($1.70{\pm}0.853$) and 'post-avulsed tooth treatment'($1.78{\pm}0.774$) by 5-point Likert scale. Likewise, the scores were $2.02{\pm}0.806$ in the question 'treatment of maxillofacial trauma', $2.76{\pm}1.061$ in the question 'emergent care of avulsed tooth', $2.70{\pm}1.095$ in the question 'treatment time of avulsed tooth' and $2.79{\pm}1.056$ in the question 'mouth guard', respectively. Compared to EMT, results of RN showed a statistically lower figure(p<0.05) in all items compared except the question 'medicine control', and the question 'doctor care in emergency room' was borderline(p=0.069). From this study, it is necessary for RN and student of nursing science to be educated on the oral and maxillofacial emergency treatment for the initial management of injuries. Authors suggest further co-study and nation-wide research with nursing care.