1.Bowel Injury and Insidious Pneumoperitoneum after Lateral Lumbar Interbody Fusion
Eui Seung HWANG ; Kook Jong KIM ; Choon Sung LEE ; Mi Young LEE ; So Jung YOON ; Jae Woo PARK ; Jae Hwan CHO ; Dong-Ho LEE
Asian Spine Journal 2022;16(4):486-492
Methods:
A total of 90 patients underwent APCT within 48 hours of surgery. Medical records were reviewed to determine each patient’s age, sex, body mass index, medical and surgical histories, characteristics of LLIF procedures, and subjective symptoms and abnormal findings in the physical examination related to acute abdomen after surgery. Various parameters were compared between patients with and without pneumoperitoneum.
Results:
Bowel injuries were identified in the first two patients and five patients (5.5%) were diagnosed with pneumoperitoneum only on APCT. We found that the greater the number of fused segments, the higher the incidence of postoperative bowel injury and/or pneumoperitoneum. The incidence was significantly high when the L2–3 level was included in the LLIF surgery.
Conclusions
Pneumoperitoneum after LLIF indicates damage to the peritoneum and the presence of bowel injury that may lead to peritonitis. However, it is difficult to distinguish pneumoperitoneum and/or bowel injury from general abdominal pain after surgery because patients may present with a wide range of symptoms. We recommend that APCT be routinely performed after LLIF surgery in order to promptly identify pneumoperitoneum and bowel injury.
2.2020 Clinical Practice Guideline for Percutaneous Transthoracic Needle Biopsy of Pulmonary Lesions: A Consensus Statement and Recommendations of the Korean Society of Thoracic Radiology
Soon Ho YOON ; Sang Min LEE ; Chul Hwan PARK ; Jong Hyuk LEE ; Hyungjin KIM ; Kum Ju CHAE ; Kwang Nam JIN ; Kyung Hee LEE ; Jung Im KIM ; Jung Hee HONG ; Eui Jin HWANG ; Heekyung KIM ; Young Joo SUH ; Samina PARK ; Young Sik PARK ; Dong-Wan KIM ; Miyoung CHOI ; Chang Min PARK
Korean Journal of Radiology 2021;22(2):263-280
Percutaneous transthoracic needle biopsy (PTNB) is one of the essential diagnostic procedures for pulmonary lesions. Its role is increasing in the era of CT screening for lung cancer and precision medicine. The Korean Society of Thoracic Radiology developed the first evidence-based clinical guideline for PTNB in Korea by adapting pre-existing guidelines. The guideline provides 39 recommendations for the following four main domains of 12 key questions: the indications for PTNB, pre-procedural evaluation, procedural technique of PTNB and its accuracy, and management of post-biopsy complications. We hope that these recommendations can improve the diagnostic accuracy and safety of PTNB in clinical practice and promote standardization of the procedure nationwide.
3.Quantitative cone-beam computed tomography evaluation of hard and soft tissue thicknesses in the midpalatal suture region to facilitate orthodontic mini-implant placement
Song-Hee OH ; Sae Rom LEE ; Jin-Young CHOI ; Seong-Hun KIM ; Eui-Hwan HWANG ; Gerald NELSON
The Korean Journal of Orthodontics 2021;51(4):260-269
Objective:
To identify the most favorable sites that optimize the initial stability and survival rate of orthodontic mini-implants, this study measured hard and soft tissue thicknesses in the median and paramedian regions of the palate using cone-beam computed tomography (CBCT) and determined possible sexand age-related differences in these thicknesses.
Methods:
The study sample comprised CBCT images of 189 healthy subjects. The sample was divided into four groups according to age. A grid area was set for the measurement of hard and soft tissue thicknesses in the palate. Vertical lines were marked at intervals of 0, 1.5, and 3.0 mm lateral to the midpalatal suture, while horizontal lines were marked at 2-mm intervals up to 24 mm from the posterior margin of the incisive foramen. Measurements were made at 65 points of intersection between the horizontal and vertical lines.
Results:
The palatal hard tissue thickness decreased from the anterior to the posterior region, with a decrease in the medial-to-lateral direction in the middle and posterior regions. While the soft tissue was rather thick around the lateral aspects of the palatal arch, it formed a constant layer that was only 1–2-mm thick throughout the palate. Statistically significant differences were observed according to sex and age.
Conclusions
The anterolateral palate as well as the midpalatal suture seem to be the most favorable sites for insertion of orthodontic mini-implants. The thickness of the palate differed by age and sex; these differences should be considered while planning the placement of orthodontic mini-implants.
4.Root proximity of the anchoring miniscrews of orthodontic miniplates in the mandibular incisal area: Cone-beam computed tomographic analysis
Do-Min JEONG ; Song Hee OH ; HyeRan CHOO ; Yong-Suk CHOI ; Seong-Hun KIM ; Jin-Suk LEE ; Eui-Hwan HWANG
The Korean Journal of Orthodontics 2021;51(4):231-240
Objective:
This outcome analysis study evaluated the actual positions of the orthodontic miniplate and miniplate anchoring screws (MPASs) and the risk factors affecting adjacent anatomic structures after miniplate placement in the mandibular incisal area.
Methods:
Cone-beam computed tomographic images of 97 orthodontic miniplates and their 194 MPASs (diameter, 1.5 mm; length, 4 mm) in patients whose miniplates provided sufficient clinical stability for orthodontic treatment were retrospectively reviewed. For evaluating the actual positions of the miniplates and analyzing the risk factors, including the effects on adjacent roots, MPAS placement height (PH), placement depth (PD), plate angle (PA), mental fossa angle (MA), and root proximity were assessed using the paired t-test, analysis of variance, and generalized linear model and regression analyses.
Results:
The mean PDs of MPASs at positions 1 (P1) and 2 (P2) were 2.01 mm and 2.23 mm, respectively. PA was significantly higher in the Class III malocclusion group than in the other groups. PH was positively correlated with MA and PD at P1. Of the 97 MPASs at P1, 49 were in the no-root area and 48 in the dentulous area; moreover, 19 showed a degree of root contact (19.6%) without root perforation. All MPASs at P2 were in the no-root area.
Conclusions
Positioning the miniplate head approximately 1 mm lower than the mucogingival junction is highly likely to provide sufficient PH for the P1-MPASs to be placed in the no-root area.
5.Quantitative cone-beam computed tomography evaluation of hard and soft tissue thicknesses in the midpalatal suture region to facilitate orthodontic mini-implant placement
Song-Hee OH ; Sae Rom LEE ; Jin-Young CHOI ; Seong-Hun KIM ; Eui-Hwan HWANG ; Gerald NELSON
The Korean Journal of Orthodontics 2021;51(4):260-269
Objective:
To identify the most favorable sites that optimize the initial stability and survival rate of orthodontic mini-implants, this study measured hard and soft tissue thicknesses in the median and paramedian regions of the palate using cone-beam computed tomography (CBCT) and determined possible sexand age-related differences in these thicknesses.
Methods:
The study sample comprised CBCT images of 189 healthy subjects. The sample was divided into four groups according to age. A grid area was set for the measurement of hard and soft tissue thicknesses in the palate. Vertical lines were marked at intervals of 0, 1.5, and 3.0 mm lateral to the midpalatal suture, while horizontal lines were marked at 2-mm intervals up to 24 mm from the posterior margin of the incisive foramen. Measurements were made at 65 points of intersection between the horizontal and vertical lines.
Results:
The palatal hard tissue thickness decreased from the anterior to the posterior region, with a decrease in the medial-to-lateral direction in the middle and posterior regions. While the soft tissue was rather thick around the lateral aspects of the palatal arch, it formed a constant layer that was only 1–2-mm thick throughout the palate. Statistically significant differences were observed according to sex and age.
Conclusions
The anterolateral palate as well as the midpalatal suture seem to be the most favorable sites for insertion of orthodontic mini-implants. The thickness of the palate differed by age and sex; these differences should be considered while planning the placement of orthodontic mini-implants.
6.Root proximity of the anchoring miniscrews of orthodontic miniplates in the mandibular incisal area: Cone-beam computed tomographic analysis
Do-Min JEONG ; Song Hee OH ; HyeRan CHOO ; Yong-Suk CHOI ; Seong-Hun KIM ; Jin-Suk LEE ; Eui-Hwan HWANG
The Korean Journal of Orthodontics 2021;51(4):231-240
Objective:
This outcome analysis study evaluated the actual positions of the orthodontic miniplate and miniplate anchoring screws (MPASs) and the risk factors affecting adjacent anatomic structures after miniplate placement in the mandibular incisal area.
Methods:
Cone-beam computed tomographic images of 97 orthodontic miniplates and their 194 MPASs (diameter, 1.5 mm; length, 4 mm) in patients whose miniplates provided sufficient clinical stability for orthodontic treatment were retrospectively reviewed. For evaluating the actual positions of the miniplates and analyzing the risk factors, including the effects on adjacent roots, MPAS placement height (PH), placement depth (PD), plate angle (PA), mental fossa angle (MA), and root proximity were assessed using the paired t-test, analysis of variance, and generalized linear model and regression analyses.
Results:
The mean PDs of MPASs at positions 1 (P1) and 2 (P2) were 2.01 mm and 2.23 mm, respectively. PA was significantly higher in the Class III malocclusion group than in the other groups. PH was positively correlated with MA and PD at P1. Of the 97 MPASs at P1, 49 were in the no-root area and 48 in the dentulous area; moreover, 19 showed a degree of root contact (19.6%) without root perforation. All MPASs at P2 were in the no-root area.
Conclusions
Positioning the miniplate head approximately 1 mm lower than the mucogingival junction is highly likely to provide sufficient PH for the P1-MPASs to be placed in the no-root area.
7.Treatment of a Horizontally Impacted and Dilacerated Maxillary Central Incisor and an Impacted Canine
Seong-Hun KIM ; Kyu-Rhim CHUNG ; Eui-Hwan HWANG ; Gerald NELSON
Journal of Korean Dental Science 2021;14(1):40-45
During orthodontic treatment of impacted teeth, use of appropriate anchorage against the traction force is important. Tooth anchorage with multi-bracket appliances is commonly used but sometimes it causes unwanted movements of adjacent teeth. Skeletal anchorage devices are therefore considered to minimize such side effects. Still their survival rate and positioning are highly limited according to the bone density and the interradicular space. This case report presents a case of two impacted teeth, one of which is dilacerated and horizontally angulated. Using the microplate with short screws and a bendable neck, negative effects on adjacent teeth were minimized and impacted teeth were repositioned with good stability.
8.Cone-beam computed tomography of mandibular foramen and lingula for mandibular anesthesia
Byeong-Seob AHN ; Song Hee OH ; Chong-Kwan HEO ; Gyu-Tae KIM ; Yong-Suk CHOI ; Eui-Hwan HWANG
Imaging Science in Dentistry 2020;50(2):125-132
Purpose:
The positions of the mandibular foramen (MnF) and the lingula affect the success rate of inferior alveolar nerve block. The objective of this study was to investigate aspects of the MnF and the lingula relevant for mandibular block anesthesia using cone-beam computed tomography (CBCT).
Materials and Methods:
Fifty CBCT scans were collected from a picture archiving and communications system. All scans were taken using an Alphard Vega 3030 (Asahi Roentgen Co. Ltd., Kyoto, Japan). Fifty-eight MnFs of 30 subjects were included in the study. The position of the MnF, the size of the MnF, the position of the lingula, the size of the lingula, and the shape of the lingula were measured and recorded. All data were statistically analyzed at a significance level of p<0.05.
Results:
The position of MnF was 0.1 mm and 0.8 mm below the occlusal plane in males and females, respectively. The horizontal position of the MnF was slightly anterior to the center of the ramus in males and in the center in females (p<0.05). The vertical position of the MnF was lower in females than in males (p<0.05). The MnF was an oval shape with a longer anteroposterior dimension. The height of the lingula was 9.3 mm in males and 8.2 mm in females. The nodular type was the most common shape of the lingula, followed by the triangular, truncated, and assimilated types.
Conclusion
CBCT provided useful information about the MnF and lingula. This information could improve the success rate of mandibular blocks.
9.Identifying Long-Term Survival Candidates among Patients with Isolated Locoregionally Recurrent Breast Cancer: Implications of the Use of Systemic Chemotherapy
Byoung Hyuck KIM ; Kyung Hwan SHIN ; Eui Kyu CHIE ; Jin Ho KIM ; Kyubo KIM ; Ki-Tae HWANG ; Jongjin KIM ; In Sil CHOI ; Jin Hyun PARK ; Suzy KIM
Journal of Breast Cancer 2020;23(3):279-290
Purpose:
We aimed to investigate the clinicopathologic factors associated with distant metastasis (DM) and post-recurrence overall survival (OS) after salvage treatments for isolated locoregional recurrence (ILRR) of breast cancer and identify long-term surviving patients for providing a more personalized therapy.
Methods:
We analyzed 125 patients who underwent salvage local treatments for ILRR after initial curative breast surgery.
Results:
Fifty-two (41.6%) patients experienced secondary recurrence or disease progression, of which 20 (38.5%) experienced a secondary locoregional recurrence and 40 (76.9%) experienced DM as the first site of failure. In multivariate analysis of distant metastasis free survival (DMFS) and post-recurrence OS, the initial pN2-3 stage, a disease-free interval of < 36 months, and non-curative resection for recurrent disease were independently poor prognosticators. The score for patients stratified according to the number of risk factors increased from 0 to 3; the corresponding 5-year DMFS rates were 91.4%, 53.0%, 35.9%, and 0% and the 5-year OS rates were 97.3%, 70.4%, 32.7%, and 25.0%, respectively (p < 0.001).Systemic chemotherapy reduced DM in patients with a score of 2–3, but it did not in those with a score of 0-1.
Conclusion
Our collective stratification can help with prognosis prediction for ILRR of breast cancer. Depending on the DM risk of patients, the potential combination of systemic therapy should be discussed further.
10.Power Doppler ultrasound-guided sialography using the phenomenon of increased blood flow: A technical report
Song Hee OH ; Yu Kyeong SEO ; Gyu Tae KIM ; Yong Suk CHOI ; Eui Hwan HWANG
Imaging Science in Dentistry 2019;49(4):301-306
PURPOSE: This report presents a procedure for performing power Doppler ultrasound-guided sialography using the phenomenon of increased blood flow and illustrates its application to practical patient cases.MATERIALS AND METHODS: The salivary gland was scanned using ultrasound equipment (GE LOGIQ5 Expert® device; GE Medical Systems, Milwaukee, WI, USA) to identify pathological findings related to the patient's chief complaint. To identify the orifice of the main duct, it should be cannulated using a lacrimal dilator. After inserting the catheter into the cannulated main duct, the position of the catheter within the duct was confirmed by ultrasound. A contrast agent was injected until the patient felt fullness, and ultrasound (B-mode) was used to confirm whether the contrast agent filled the main canal and secondary and tertiary ducts. Then, power Doppler ultrasound was performed to determine whether the salivary gland had increased blood flow.RESULTS: In 2 cases in this report, a power Doppler ultrasound scan showed a significant increase in blood flow after contrast medium injection, which was not observed on a preoperative scan.CONCLUSION: Power Doppler ultrasound was found to be a simple, safe, and effective tool for real-time sialography monitoring.
Catheters
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Humans
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Salivary Glands
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Sialography
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Ultrasonography
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Vasodilation

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