• 제목/요약/키워드: whole body bone scan

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Clinical investigation of bisphosphonate-related osteonecrosis of the jaws in patients with malignant tumors

  • Kim, Sei-Kyoung;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제38권3호
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    • pp.152-159
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    • 2012
  • Objectives: This study evaluated bisphosphonate-related osteonecrosis of the jaws (BRONJ) in patients diagnosed with malignant bone tumors. Demographic findings, laboratory, and radiographic analyses were performed to characterize disease severity and progression. Materials and Methods: Patients who had been diagnosed with BRONJ (2005-2010) at the authors' hospital according to the American Association of Oral and Maxillofacial Surgeons were investigated. Twenty-one patients (12 with multiple myelomas, 7 with breast cancer, and 2 with prostate cancer) who had been treated with bisphosphonates (BPs) for malignant bone tumors were included. Radiographic evaluations with a panorama, computed tomography, whole body bone scan, and laboratory findings were evaluated for erythrocyte sedimentation rate (ESR), c-reactive proteins (CRPs), and c-terminal cross-linked telopeptides (CTXs). Results: The average age of the patients was 64.3 (range 51-80), and they were treated with BPs for an average of $35{\pm}19$ months before BRONJ was diagnosed. Types of BPs were zolendronic acid (81%, intravenous [IV]), pamidronate (4.8%, IV), zoledronic acid+pamidronate (4.8%, IV), alendronate (4.8%, per os [PO]), and ibadronate (4.75%, PO). Extraction (67%) and persistent irritation of dentures (20%) were the most common triggering factors. BRONJ in the mandible was reported in 62% of the cases, in the maxilla 24%, and both 14%. BRONJ occurred more frequently in patients with multiple myelomas (n=12, 57.1%). Most of the patients revealed an advanced BRONJ stage; Stage I (n=2, 9%), Stage II (n=13, 62%), and Stage III (n=6, 29%). Conclusion: The differences of the ESR, CRP, and CTX values between the BRONJ-recurring and non-recurring patients after the treatment were not evident. Later stage BRONJ patients showed lower CTX levels. A drug holiday after the diagnosis of BRONJ did not remarkably influence the surgical outcomes. However, the limited number of patients in the study should be considered.

Corticosteroid를 이용한 하악에 발현된 Langerhans Cell Histiocytosis의 치료 : 증례보고 (USE OF CORTICOSTEROIDS IN THE TREATMENT OF LOCALIZED LANGERHANS CELL HISTIOCYTOSIS OF THE MANDIBLE : CASE REPORT)

  • 최정용;이상화;윤현중
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제31권3호
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    • pp.249-253
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    • 2009
  • Langerhans cell histiocytosis(LCH), previously known as histiocytosis X, is rare, proliferative disorder in which the accumulation of pathologic Langerhans cell leads to tissue infiltration and destruction. The jaw is involved 10~20% of all LCH and most common oral symptoms are jaw swelling or a palpation mass. Most of subjects are males and disease appears to start before the age of 10 years. An 11 years old girl was referred from pediatric department. Histological examination confirmed the diagnosis LCH. She was treated intra-lesional injection of corticosteroid. The overall outcome was excellent. After a follow-up period of 20 month, the patient present with no evidence of residual disease on Panoramic view and whole body bone scan. We report this early recognized LCH case treated by corticoid injection in good progress with literature review.

시신경에 발생한 전이성 선세포암 - 증 례 보 고 - (Metastatic Adenocarcinoma of Optic Nerve - A Case Report -)

  • 김진용;박상근;김한성;신형식;황용순;김상진
    • Journal of Korean Neurosurgical Society
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    • 제29권8호
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    • pp.1069-1073
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    • 2000
  • Although the most commonly encountered orbital tumor is metastatic tumor, adenocarcinoma of stomach metastasized to the optic nerve is rarely reported. The authors discuss a rare case of metastatic adenocarcinoma of left optic nerve with a review of literature. A 44-year-old man presented with decreased visual acuity of left eye for 3 months. Neurologic examination revealed left optic neuropathy. On MR imaging, a homogenously wellenhanced mass surrounding left optic nerve around optic canal was noticed. The X-rays and the whole body bone scan sho-wed multiple bony metastasis. Subtotal removal was performed via combined subfrontal and pterional approach and metastatic adenocarcinoma from the stomach was confirmed histologically. Postoperative course was uneventful, but there was no improvement of visual acuity.

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이하선에서 발견된 MALT 림프종 1례 (A Case report of MALT lymphoma in parotid gland)

  • 김명희;최종중;안홍근;박중수;김연수
    • 대한두경부종양학회지
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    • 제35권1호
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    • pp.33-36
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    • 2019
  • Mucosa-associated lymphoid tissue (MALT) lymphoma has specific clinical and pathologic features. The most common site MALT lymphomas is the stomach; however, it can also occur in other organs, such as the salivary glands. MALT lymphoma is rare, but its prognosis is good. A 32-year-old man visited Konyang university hospital with parotid mass. Superficial partial parotidectomy was performed to exclude lymphoid neoplasms. IgH gene rearrangement analysis of the surgical specimen led to the diagnosis of MALT lymphoma. The patient underwent esophagogastroduodenoscopy, positron emission tomography-computed tomography, and whole-body bone scan. Regional or distant metastasis was not observed on staging workup. The patient underwent postoperative radiation therapy, there has been no recurrence of MALT lymphoma to date. Here, we report this rare case of parotid MALT lymphoma that was treated with surgery and postoperative radiation therapy.

Mucosa-associated lymphoid tissue lymphoma on right lower eyelid previously diagnosed as lymphoid hyperplasia

  • Kim, Yang Seok;Na, Young Cheon;Huh, Woo Hoe;Kim, Ji Min
    • 대한두개안면성형외과학회지
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    • 제20권1호
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    • pp.66-70
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    • 2019
  • Mucosa-associated lymphoid tissue (MALT) lymphoma is an uncommon form of non-Hodgkin lymphoma involving the mucosa-associated lymphoid tissue. Most commonly affected organ is the stomach. But, it could affect almost every organ in the whole body. If they have suspicious lesion, excision biopsy could be made. For staging, blood test including blood smear, abdomen and chest tomography or scan will be checked. Also, bone marrow test can be done if it is needed. The patient had visited the clinic for palpable mass on right lower eyelid. With excisional biopsy, it was diagnosed as lymphoid hyperplasia on pathologic test. But 2 years later, the patient came with recurrent symptom for our department with worry. At that time, we recommended excisional soft tissue biopsy under general anesthesia. Unfortunately, it was revealed MALT lymphoma on pathologic finding. It turned out to be stage 3 in Ann Arbor staging system without B symptoms. Hematologic consultation was made and she was treated with adjuvant chemotherapy for eight cycles to complete remission. We report a case of MALT lymphoma on subcutaneous tissue at right lower eyelid previously diagnosed as lymphoid hyperplasia.

사후전산화단층촬영의 법의병리학 분야 활용을 위한 조건부 적대적 생성 신경망을 이용한 CT 영상의 해상도 개선: 팬텀 연구 (Enhancing CT Image Quality Using Conditional Generative Adversarial Networks for Applying Post-mortem Computed Tomography in Forensic Pathology: A Phantom Study)

  • 윤예빈;허진행;김예지;조혜진;윤용수
    • 대한방사선기술학회지:방사선기술과학
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    • 제46권4호
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    • pp.315-323
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    • 2023
  • Post-mortem computed tomography (PMCT) is commonly employed in the field of forensic pathology. PMCT was mainly performed using a whole-body scan with a wide field of view (FOV), which lead to a decrease in spatial resolution due to the increased pixel size. This study aims to evaluate the potential for developing a super-resolution model based on conditional generative adversarial networks (CGAN) to enhance the image quality of CT. 1761 low-resolution images were obtained using a whole-body scan with a wide FOV of the head phantom, and 341 high-resolution images were obtained using the appropriate FOV for the head phantom. Of the 150 paired images in the total dataset, which were divided into training set (96 paired images) and validation set (54 paired images). Data augmentation was perform to improve the effectiveness of training by implementing rotations and flips. To evaluate the performance of the proposed model, we used the Peak Signal-to-Noise Ratio (PSNR), Structural Similarity Index Measure (SSIM) and Deep Image Structure and Texture Similarity (DISTS). Obtained the PSNR, SSIM, and DISTS values of the entire image and the Medial orbital wall, the zygomatic arch, and the temporal bone, where fractures often occur during head trauma. The proposed method demonstrated improvements in values of PSNR by 13.14%, SSIM by 13.10% and DISTS by 45.45% when compared to low-resolution images. The image quality of the three areas where fractures commonly occur during head trauma has also improved compared to low-resolution images.

젊은 여성에서 임신 및 수유와 연관된 골다공증성 척추 압박골절 (Osteoporotic Vertebral Compression Fracture Associated with Pregnancy and Lactation in Young Women)

  • 신우진;서승표;염지웅;김윤성
    • 대한정형외과학회지
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    • 제56권3호
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    • pp.266-271
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    • 2021
  • 임신 및 수유와 연관된 골다공증은 젊은 여성에서 골다공증성 척추 압박골절을 일으킬 수 있는 희귀한 질환이다. 환자들은 주로 요통을 호소하며, 이는 임신과 출산, 수유에 의한 통증으로 오인되기 쉬워 빠른 진단과 치료가 어렵다. 저자들은 요통을 주소로 내원한 29세 여자 환자와 31세 여자 환자에 대해 신체 진찰, 단순 방사선 검사, 전신 골주사 검사, 자기공명영상 검사, 골밀도 검사, 혈액 검사 등을 통하여 임신과 수유에 연관된 골다공증성 척추 압박골절을 진단하였으며, 테리파라타이드(teriparatide) 주사와 흉요천추 보조기 착용, 칼슘과 비타민 D 제제 복용을 통해 증상이 호전된 2예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Fungal Osteomyelitis of Temporomandibular Joint and Skull Base Caused by Chronic Otitis Media

  • Kim, Bok Eum;Park, Keun Jeong;Lee, Jung Eun;Park, YounJung;Kwon, Jeong-Seung;Kim, Seong-Taek;Choi, Jong-Hoon;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • 제45권1호
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    • pp.12-16
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    • 2020
  • Chronic otitis media (COM) is a chronic inflammatory disease which affects the middle ear, mastoid cavity. It presents hearing loss, ear pain, dizziness, headache, temporomandibular joint (TMJ) inflammation and intracranial complication. Intracranial complications such as skull base osteomyelitis (SBO) may occur secondary to COM due to transmission of infection by a number of possible routes. SBO is an uncommon condition with a significant morbidity and mortality if not treated in the early stages. We report a-67-year-old male patient with diabetes and untreated COM who presented atypical severe TMJ, periorbital and postmandibular pain. By computerized tomography (CT), magnetic resonance imaging (MRI) and whole body bone scan (WBBS), he was diagnosed with SBO spreading from untreated COM via infective arthritis of TMJ. Through this case, we suggest proper utilization of diagnostic imaging, especially CT or MRI for the early detection of SBO in the case of COM accompanying with the greater risk of infection developments such as diabetes.

Total En Bloc Thoracic and Lumbar Spondylectomy for Non-Small Cell Lung Cancer with Favorable Prognostic Indicators : Is It Merely Indicated for Solitary Spinal Metastasis?

  • Park, Jong-Hwa;Hyun, Seung-Jae;Kim, Ki-Jeong;Jahng, Tae-Ahn
    • Journal of Korean Neurosurgical Society
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    • 제56권5호
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    • pp.431-435
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    • 2014
  • A fifty-year-old female non-smoker with no other specific medical history visited our institute. She complained of axial back pain with no other neurological deficit. Chest X-ray, chest computed tomography (CT) scan, CT-guided needle aspiration biopsy, whole-body positron emission tomography, spine CT and spine magnetic resonance image findings suggested NSCLC with epidermal growth factor receptor (EGFR) mutation, multiple brain metastases, and two isolated metastases to the T3 and L3 vertebral bodies. She underwent chemotherapy with gefitinib ($Iressa^{TM}$) for NSCLC and gamma knife surgery for multiple brain metastases. We performed a two-staged, total en bloc spondylectomy of the T3 and L3 vertebral bodies based on several good prognostic characteristics, such as the lack of metastases to the appendicular bone, good preoperative performance status, and being an excellent responder (Asian, never-smoker and adenocarcinoma histology) to EGFR inhibitors. Improved axial back pain after the surgery enabled her to walk with the aid of a thoracolumbosacral orthosis brace on the third postoperative day. Her Karnofsky performance status score (KPS) was 90 at the time of discharge and has been maintained to date 3 years after surgery. In selected NSCLC patients with good prognostic characteristics, we suggest that locally curative treatment such as total en bloc spondylectomy or radiosurgery should be emphasized to achieve longer term survival for the selected cases.

우측 협부에 발생한 윤활막육종 증례보고 (A Case Report of Synovial Sarcoma of the Face)

  • 허정;이근철;박정민;김석권;노미숙;이진화
    • Archives of Plastic Surgery
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    • 제32권6호
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    • pp.760-762
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    • 2005
  • Synovial Sarcoma is the fourth most common sarcoma, accounting for 8-10 % of all sarcomas. Synovial sarcoma is highly malignant tumor of mesenchymal origin but rarely occurres in head and neck area. Less than 100 cases of synovial sarcoma occurring in head and neck area have been reported all over the world. Pathologically, there is two type of synovial sarcoma: monophasic variant is composed of only one cell type and "classic" (biphasic) synovial sarcoma has two cellular component, a spindle cell(fibrosarcoma-like) component and a pseudoepithelioma component. Recommended treatment is wide resection with negative margins. The role of chemotherapy and radiation therapy is controversial. We experienced a 42-year-old male patient with slowly enlarging, deep seated mass on right cheek. In the first operation, we suggested that the mass maybe benign tumor. But, initial excisional biopsy specimen of the primary lesion was consistent with synovial sarcoma. The final diagnosis was monophasic synovial sarcoma which was composed of spindle cells. Radical resection was performed two months later because remnant tumor was found on follow up MRI. No further treatment was done. There were no recurrence or metastasis on follow up MRI, chest CT and whole body bone scan after 15 months. This is a report of a rare case of synovial sarcoma of the face with a literature review.