Displaying publications 1 - 20 of 1490 in total

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  1. Syahrom A, Abdul Kadir MR, Harun MN, Öchsner A
    Med Eng Phys, 2015 Jan;37(1):77-86.
    PMID: 25523865 DOI: 10.1016/j.medengphy.2014.11.001
    Artificial bone is a suitable alternative to autografts and allografts, however their use is still limited. Though there were numerous reports on their structural properties, permeability studies of artificial bones were comparably scarce. This study focused on the development of idealised, structured models of artificial cancellous bone and compared their permeability values with bone surface area and porosity. Cancellous bones from fresh bovine femur were extracted and cleaned following an established protocol. The samples were scanned using micro-computed tomography (μCT) and three-dimensional models of the cancellous bones were reconstructed for morphology study. Seven idealised and structured cancellous bone models were then developed and fabricated via rapid prototyping technique. A test-rig was developed and permeability tests were performed on the artificial and real cancellous bones. The results showed a linear correlation between the permeability and the porosity as well as the bone surface area. The plate-like idealised structure showed a similar value of permeability to the real cancellous bones.
    Matched MeSH terms: Tomography, X-Ray Computed
  2. Azhan, A., Mutasim, H., Abdul-Hadi, R., Khairul-Anwar, I., Zunaina, E.
    MyJurnal
    Macular branch retinal vein occlusion (BRVO), a type of retinal vein occlusion, is rarely recognised as a distinct entity. Macular BRVO has unique clinical features and different natural courses than the major BRVO. We report a case of a young patient with macular BRVO with macular oedema who was successfully treated with intravitreal ranibizumab injection. A 43 year-old Chinese man with no underlying medical illness presented with 2 weeks history of left eye painless reduced central vision which was worsening over time. On examination, his left eye visual acuity was 6/30 and Amsler chart drawing showed a lower central scotoma. Dilated fundus examination found marked flame-shaped retinal hemorrhages with cotton wool spot over the superior macular area bounded superiorly by superior arcade and macular thickening. An optical coherence tomography revealed cystoid macular oedema; and fundus fluorescein angiography showed occlusion of a small venous branch draining a superior part of macula to superior temporal venous arcade. A complete medical investigation found that he has hypertriglyceridemia and he was managed accordingly. His vision had improved to 6/6 after receiving 3 injections of intravitreal ranibizumab with no residual central scotoma and complete resolution of macular oedema.
    Matched MeSH terms: Tomography, Optical Coherence
  3. Vinuthinee N, Azreen-Redzal A, Juanarita J, Zunaina E
    Int Med Case Rep J, 2015;8:47-50.
    PMID: 25709507 DOI: 10.2147/IMCRJ.S75198
    We report a rare case of sling shot injury that presented with a gunshot-like wound with preseptal cellulitis, in a toddler. An 11-month-old Malay child presented with a gunshot-like wound over the forehead following sling shot injury. On examination, he had a deep circular laceration wound over the forehead, measuring 2.0 cm in diameter, with minimal bleeding. There was no obvious foreign body seen inside the wound and no palpable foreign body surrounding the wound. The gunshot-like wound was associated with left preseptal cellulitis. A skull X-ray showed a white opaque foreign body in the left frontal bone. Computed tomography (CT) scan of orbit and brain revealed a left comminuted fracture of the left orbital roof, and left frontal brain contusion with prelesional edema. Wound exploration was performed and revealed a 0.5 cm unshattered marble embedded in the left frontal bone. The marble and bone fragments were removed. The left preseptal cellulitis responded well to intravenous antibiotic and topical antibiotic.
    Matched MeSH terms: Tomography; Tomography, X-Ray Computed
  4. Sarojini K, Ling KP, Teh WM, Ali H, Zunaina E
    Cureus, 2020 Sep 07;12(9):e10297.
    PMID: 33047087 DOI: 10.7759/cureus.10297
    We report a case of optic disc drusen (ODD) associated with peripapillary polypoidal choroidal vasculopathy (PCV). A 62-year-old Malay lady presented with both eye ODD and the left eye associated with peripapillary subretinal hemorrhage. Ultrasound B-scan and red-free photography confirmed the optic nerve head drusen findings bilaterally. Optical coherence tomography (OCT) of the left eye showed sharply elevated peripapillary pigment epithelial detachment with subretinal fluid. The presence of peripapillary polyps with branching vascular network in indocyanine green angiography of the left eye further confirmed the diagnosis of PCV and excluded choroidal neovascularization (CNV) secondary to ODD. Subsequently, the patient was treated with a combination of verteporfin photodynamic therapy with three monthly intravitreal ranibizumab injections. Three months after the combined treatment, OCT showed completely resolved subretinal fluid. ODD can cause compression of the subretinal vessels at the optic disc that results in retinal ischemia and release of vascular endothelial growth factor, which may trigger the development of CNV or PCV. The rarity of this combination makes it interesting to study more cases of ODD with PCV. Importantly, a thorough evaluation in distinguishing the PCV from the CNV that mimics it is crucial for early detection and prompt intervention. In this case, indocyanine green angiography (ICGA) is the diagnostic method to differentiate the PCV from CNV secondary to ODD.
    Matched MeSH terms: Tomography, Optical Coherence
  5. Dorai AA, Halim AS, Zulmi W
    Med J Malaysia, 2004 Dec;59 Suppl F:42-6.
    PMID: 15941160
    Reconstructive surgeons often encounter complex soft tissue and skeletal defects following oncological surgery. Soft tissue defects after wide resection in upper extremities posses a difficult challenge to find adequate tissue for reconstructing these defects. Paucity of local tissues dictates the requirement of loco-regional or distant flaps for these complex soft tissue defects which often exposes tendons, bones, nerves and joints. The latissimus dorsi muscle is a near ideal flap for the reconstruction because of the long neurovascular pedicle, ease of mobilization and its expendability. It can be rotated, with or without overlying skin, to cover soft tissue defects of the shoulder arm and elbow. Due to the large size of the muscle, it can be used to resurface the soft tissue defects and cover all major structures. Eleven consecutive cases were reviewed in which latissimus dorsi myocutaneous flap was used to reconstruct soft tissue defects of the upper limb following radical tumor resection. Flap survival was 100% with nominal donor site morbidity.
    Matched MeSH terms: Tomography, X-Ray Computed
  6. Abidin ZAZ, Hayati F, Tan GH, Goh EH, Hafidzul J, Zulkifli MZ
    J Coll Physicians Surg Pak, 2018 Mar;28(3):S69-S70.
    PMID: 29482714 DOI: 10.29271/jcpsp.2018.03.S69
    A 46-year gentleman presented with a left-sided lumbar region pain without fever or dysuria. He denied episodes of acute urinary retention. There was a hard mass at the distal urethra with normal laboratory blood tests. Computed tomography urogram revealed a concurrent left renal staghorn calculus and large distal urethral stone. The urethral stone was fragmented via endourologic technique successfully. We report a case of a non-obstructing large urethral calculus in a gentleman with concurrent left renal staghorn calculus and discuss the literature review.
    Matched MeSH terms: Tomography, X-Ray Computed*
  7. Hamizah R, Rohana AG, Anwar SA, Ong TZ, Hamzaini AH, Zulkarnaen AN
    Med J Malaysia, 2007 Mar;62(1):70-1.
    PMID: 17682577 MyJurnal
    We report a case of a previously healthy 38-year old lady who presented with prolonged fever and hepatosplenomegaly. Intensive investigations were performed for pyrexia of unknown origin which revealed negative. CT scan of the abdomen showed multiple hypodense lesions which did not respond to broad-spectrum antibiotics. Percutaneous biopsy of the splenic lesion revealed granuloma formation and Langhan's giant cells suggestive of TB. She responded well with anti- TB medication but required extended treatment duration of 24 months due to persistence of the splenic lesion on repeated CT scans. This case illustrates a very rare clinical entity of isolated splenic TB with a therapeutic dilemma following incomplete resolution, despite prolonged treatment.
    Matched MeSH terms: Tomography, X-Ray Computed
  8. Said MA, Musarudin M, Zulkaffli NF
    Ann Nucl Med, 2020 Dec;34(12):884-891.
    PMID: 33141408 DOI: 10.1007/s12149-020-01543-x
    OBJECTIVE: 18F is the most extensively used radioisotope in current clinical practices of PET imaging. This selection is based on the several criteria of pure PET radioisotopes with an optimum half-life, and low positron energy that contributes to a smaller positron range. In addition to 18F, other radioisotopes such as 68Ga and 124I are currently gained much attention with the increase in interest in new PET tracers entering the clinical trials. This study aims to determine the minimal scan time per bed position (Tmin) for the 124I and 68Ga based on the quantitative differences in PET imaging of 68Ga and 124I relative to 18F.

    METHODS: The European Association of Nuclear Medicine (EANM) procedure guidelines version 2.0 for FDG-PET tumor imaging has adhered for this purpose. A NEMA2012/IEC2008 phantom was filled with tumor to background ratio of 10:1 with the activity concentration of 30 kBq/ml ± 10 and 3 kBq/ml ± 10% for each radioisotope. The phantom was scanned using different acquisition times per bed position (1, 5, 7, 10 and 15 min) to determine the Tmin. The definition of Tmin was performed using an image coefficient of variations (COV) of 15%.

    RESULTS: Tmin obtained for 18F, 68Ga and 124I were 3.08, 3.24 and 32.93 min, respectively. Quantitative analyses among 18F, 68Ga and 124I images were performed. Signal-to-noise ratio (SNR), contrast recovery coefficients (CRC), and visibility (VH) are the image quality parameters analysed in this study. Generally, 68Ga and 18F gave better image quality as compared to 124I for all the parameters studied.

    CONCLUSION: We have defined Tmin for 18F, 68Ga and 124I SPECT CT imaging based on NEMA2012/IEC2008 phantom imaging. Despite the long scanning time suggested by Tmin, improvement in the image quality is acquired especially for 124I. In clinical practice, the long acquisition time, nevertheless, may cause patient discomfort and motion artifact.

    Matched MeSH terms: Positron Emission Tomography Computed Tomography/instrumentation*; Positron Emission Tomography Computed Tomography/methods*
  9. Salinawati B, Hing EY, Fam XI, Zulfiqar MA
    Med J Malaysia, 2015 Aug;70(4):238-42.
    PMID: 26358021 MyJurnal
    AIM: To determine the (i) sensitivity and specificity of ultrasound (USG) in the detection of urinary tract calculi, (ii) size of renal calculi detected on USG, and (iii) size of renal calculi not seen on USG but detected on computed tomography urogram (CTU).
    METHODS: A total of 201 patients' USG and CTU were compared retrospectively for the presence of calculi. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value of USG were calculated with CTU as the gold standard.
    RESULTS: From the 201 sets of data collected, 59 calculi were detected on both USG and CTU. The sensitivity and specificity of renal calculi detection on USG were 53% and 85% respectively. The mean size of the renal calculus detected on USG was 7.6 mm ± 4.1 mm and the mean size of the renal calculus not visualised on USG but detected on CTU was 4 mm ± 2.4 mm. The sensitivity and specificity of ureteric calculi detection on USG were 12% and 97% respectively. The sensitivity and specificity of urinary bladder calculi detection on USG were 20% and 100% respectively.
    CONCLUSION: This study showed that the accuracy of US in detecting renal, ureteric and urinary bladder calculi were 67%, 80% and 98% respectively.
    Study site: Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
    Matched MeSH terms: Tomography, X-Ray Computed
  10. Thambidorai CR, Ismail S, Chan KY, Haron A, Zulfiqar A
    Med J Malaysia, 2004 Mar;59(1):120-2.
    PMID: 15535349
    A child with a post-tramatic pancreatic pseuodocyst developed pancreatic fistula, following percutaneous drainage of the cyst. The fistula output was about 120ml/day and lasted for a month. A diagnostic ERCP revealed main pancreatic duct disruption. The fistula output ceased over the next two days following the ERCP. The patient has been well for the past four years. This patient's immediate recovery after ERCP could possibly be due to dislodgement of a mucus plug by the contrast injected during ERCP. Such a mechanism can explain the previous sporadic reports of spontaneous cure of persistent pancreatic fistulae in children.
    Matched MeSH terms: Tomography, X-Ray Computed
  11. Lim SW, Lim HY, Kannaiah T, Zuki Z
    Malays Orthop J, 2017 Nov;11(3):50-52.
    PMID: 29326768 MyJurnal DOI: 10.5704/MOJ.1711.004
    Streptococcus constellatus is an extremely rare cause of pyogenic spondylodiscitis. Literature search yielded only one case report in an elderly 72 years old man with spontaneous T10-T11 S. constellatus spondylodiscitis. It is virtually unheard of in young teenage. We report the case of a 14 years old male teenager who presented with worsening low back pain for one year with no neurological deficit. Imaging studies were consistent with features of L4-L5 spondylodiscitis. CT guided biopsy grew a pure culture of streptococcus constellatus sensitive to penicillin and erythromycin. He showed full recovery with six weeks of intravenous antibiotics. Due to the insidious onset, this case highlight the importance of high clinical suspicion and early diagnosis, with image guided biopsy followed by treatment with appropriate intravenous antibiotics to enable full recovery without further neurological deterioration.
    Matched MeSH terms: Tomography, X-Ray Computed
  12. Tan WJ, Suz CS, Azza O, Zuki M
    Med J Malaysia, 2021 03;76(2):241-244.
    PMID: 33742636
    Sarcoidosis is a chronic, multisystem disorder. A 38 years old lady presented at Hospital Raja Perempuan Zainab II, Kota Bharu ,Malaysia with cough and breathless for 2 months and constitutional symptoms of weight loss and loss of appetite. She was initially treated as smear negative pulmonary tuberculosis for 5 months. However, her clinical condition deteriorated with worsening New York Heart Association (NYHA) class 1 to class 3. Subsequently, workout of computed tomography( CT) thorax showed multiple perilymphatic distribution of nodules and multiple mediastinal lymphadenopathy coupled with pleura biopsy showed non caseating granuloma and cardiac magnetic resonance imaging (MRI) with positive late gadolinium enhancement revised the diagnosis of pulmonary sarcoidosis with cardiac involvement. Patient's functional status and cough improved with immunosuppresant was given in tapering dose fashion.
    Matched MeSH terms: Tomography, X-Ray Computed
  13. Corda JV, Shenoy BS, Ahmad KA, Lewis L, K P, Khader SMA, et al.
    Comput Methods Programs Biomed, 2022 Feb;214:106538.
    PMID: 34848078 DOI: 10.1016/j.cmpb.2021.106538
    BACKGROUND AND OBJECTIVE: Neonates are preferential nasal breathers up to 3 months of age. The nasal anatomy in neonates and infants is at developing stages whereas the adult nasal cavities are fully grown which implies that the study of airflow dynamics in the neonates and infants are significant. In the present study, the nasal airways of the neonate, infant and adult are anatomically compared and their airflow patterns are investigated.

    METHODS: Computational Fluid Dynamics (CFD) approach is used to simulate the airflow in a neonate, an infant and an adult in sedentary breathing conditions. The healthy CT scans are segmented using MIMICS 21.0 (Materialise, Ann arbor, MI). The patient-specific 3D airway models are analyzed for low Reynolds number flow using ANSYS FLUENT 2020 R2. The applicability of the Grid Convergence Index (GCI) for polyhedral mesh adopted in this work is also verified.

    RESULTS: This study shows that the inferior meatus of neonates accounted for only 15% of the total airflow. This was in contrast to the infants and adults who experienced 49 and 31% of airflow at the inferior meatus region. Superior meatus experienced 25% of total flow which is more than normal for the neonate. The highest velocity of 1.8, 2.6 and 3.7 m/s was observed at the nasal valve region for neonates, infants and adults, respectively. The anterior portion of the nasal cavity experienced maximum wall shear stress with average values of 0.48, 0.25 and 0.58 Pa for the neonates, infants and adults.

    CONCLUSIONS: The neonates have an underdeveloped nasal cavity which significantly affects their airway distribution. The absence of inferior meatus in the neonates has limited the flow through the inferior regions and resulted in uneven flow distribution.

    Matched MeSH terms: Tomography, X-Ray Computed
  14. Abubakar A, Shaukat SI, Karim NKA, Kassim MZ, Lim SY, Appalanaido GK, et al.
    Phys Eng Sci Med, 2023 Mar;46(1):339-352.
    PMID: 36847965 DOI: 10.1007/s13246-023-01227-6
    Deep inspiration breath-hold radiotherapy (DIBH-RT) reduces cardiac dose by over 50%. However, poor breath-hold reproducibility could result in target miss which compromises the treatment success. This study aimed to benchmark the accuracy of a Time-of-Flight (ToF) imaging system for monitoring breath-hold during DIBH-RT. The accuracy of an Argos P330 3D ToF camera (Bluetechnix, Austria) was evaluated for patient setup verification and intra-fraction monitoring among 13 DIBH-RT left breast cancer patients. The ToF imaging was performed simultaneously with in-room cone beam computed tomography (CBCT) and electronic portal imaging device (EPID) imaging systems during patient setup and treatment delivery, respectively. Patient surface depths (PSD) during setup were extracted from the ToF and the CBCT images during free breathing and DIBH using MATLAB (MathWorks, Natick, MA) and the chest surface displacement were compared. The mean difference ± standard deviation, correlation coefficient, and limit of agreement between the CBCT and ToF were 2.88 ± 5.89 mm, 0.92, and - 7.36, 1.60 mm, respectively. The breath-hold stability and reproducibility were estimated using the central lung depth extracted from the EPID images during treatment and compared with the PSD from the ToF. The average correlation between ToF and EPID was - 0.84. The average intra-field reproducibility for all the fields was within 2.70 mm. The average intra-fraction reproducibility and stability were 3.74 mm, and 0.80 mm, respectively. The study demonstrated the feasibility of using ToF camera for monitoring breath-hold during DIBH-RT and shows good breath-hold reproducibility and stability during the treatment delivery.
    Matched MeSH terms: Tomography, X-Ray Computed
  15. Ikhwan SM, Kenneth VK, Seoparjoo A, Zin AA
    BMJ Case Rep, 2013 Jun 21;2013.
    PMID: 23813511 DOI: 10.1136/bcr-2013-009584
    Primary primitive neuroectodermal tumour (PNET) and extraskeletal Ewing's sarcoma belongs to the Ewing's family of tumours. Primary tumours arising from breast are very rare. There are only a few case reports published on primary extraskeletal Ewing's sarcoma and PNET arising from breast. We present an extremely rare case of an inoperable primary Ewing's sarcoma arising from left breast with contralateral breast, lymphatic and lung metastasis.
    Matched MeSH terms: Tomography, X-Ray Computed
  16. Lou Y, Fan L, Hou X, Dominiczak AF, Wang JG, Staessen JA, et al.
    Hypertension, 2019 11;74(5):1068-1074.
    PMID: 31564165 DOI: 10.1161/HYPERTENSIONAHA.119.13140
    Matched MeSH terms: Positron Emission Tomography Computed Tomography/methods*
  17. Cheng J, Wang H, Wei S, Mei J, Liu F, Zhang G
    Comput Biol Med, 2024 Mar;170:108000.
    PMID: 38232453 DOI: 10.1016/j.compbiomed.2024.108000
    Alzheimer's disease (AD) is a neurodegenerative disease characterized by various pathological changes. Utilizing multimodal data from Fluorodeoxyglucose positron emission tomography(FDG-PET) and Magnetic Resonance Imaging(MRI) of the brain can offer comprehensive information about the lesions from different perspectives and improve the accuracy of prediction. However, there are significant differences in the feature space of multimodal data. Commonly, the simple concatenation of multimodal features can cause the model to struggle in distinguishing and utilizing the complementary information between different modalities, thus affecting the accuracy of predictions. Therefore, we propose an AD prediction model based on de-correlation constraint and multi-modal feature interaction. This model consists of the following three parts: (1) The feature extractor employs residual connections and attention mechanisms to capture distinctive lesion features from FDG-PET and MRI data within their respective modalities. (2) The de-correlation constraint function enhances the model's capacity to extract complementary information from different modalities by reducing the feature similarity between them. (3) The mutual attention feature fusion module interacts with the features within and between modalities to enhance the modal-specific features and adaptively adjust the weights of these features based on information from other modalities. The experimental results on ADNI database demonstrate that the proposed model achieves a prediction accuracy of 86.79% for AD, MCI and NC, which is higher than the existing multi-modal AD prediction models.
    Matched MeSH terms: Positron-Emission Tomography/methods
  18. Vinodh VP, Sellamuthu P, Harun RH, Zenian MS
    Med J Malaysia, 2014 Apr;69(2):89-91.
    PMID: 25241819 MyJurnal
    Intraorbital foreign body (IOFB) has been a rare phenomenon in the cases of gunshot wounds and always represents a dilemma in medical management. In Sabah, this scenario is becoming common as there is still certain population in the interiors who owns self made guns for hunting. They either present with self inflicted gunshot injuries or after being mistakenly shot while hunting. There are very few articles on this topic especially when it is located posteriorly in the orbit and occurs without visual impairment. This case reports the challenges faced in the management of the patient with a posteriorly located metallic IOFB. The appropriate management of the patient is discussed based on several international literatures. Author describes a 37 years old male farmer, who was referred from a nearby district hospital after he sustained gunshot injuries to his face and scalp. Urgent computed tomography (CT) scan showed that bullet pellets were at the left orbital floor, the left mandible and the left frontal bone. All bullet pellets were located extracranially only without intracranial involvement. Patient clinically does not have any neurologic deficit and without any visual impairment, thus he refused any surgical intervention. As there is no proper guideline in managing such cases, decision was made based on evidences from international literatures. It was concluded that metallic IOFB located in the posterior orbit may be conservatively managed with observation and regular follow-ups as they are well-tolerated and does not cause much impact on visual deterioration unless inflammation, infection, optic neuropathy or functional deficit occurs. This avoids unnecessary surgery and prevents risk of iatrogenic injury to the eye.
    Matched MeSH terms: Tomography; Tomography, X-Ray Computed
  19. Hisham AN, Sarojah A, Zanariah H
    Asian J Surg, 2003 Jan;26(1):40-2.
    PMID: 12527494
    A case of large adrenocortical carcinoma extending into the inferior vena cava and right atrium is reported. Computed tomography showed a large mass displacing the left kidney inferiorly with an intravascular tumour thrombus extending into the inferior vena cava and right atrium. Radical surgery under hypothermia and cardiopulmonary bypass was performed and the tumour mass, together with the tumour thrombus, was successfully removed. The presence of intravascular tumour extension alone should not be a contraindication to radical surgical therapy, as it is the best hope for prolonged survival.
    Matched MeSH terms: Tomography, X-Ray Computed
  20. Loh, Li Loong, Wong, Kai Ann, Zamzuri Zakaria@Mohamad
    MyJurnal
    Synovial osteochondromatosis is an unusual, rare and benign tumour. This disease is characteristically monoarticular, most commonly found in knee joint, however it is rarely found in the elbow. A 49-year-old Indian man presented to hospital with a 6-month history of pain, swelling, intermittent locking, loss of range of motion of right elbow and a considerable size of elbow with no recollection of associated trauma. Plain radiographs of right elbow showed numerous radiopaque round and oval loose bodies within the right elbow joints. Computer Tomographic (CT) scan showed multiple bony mass within the right elbow joint. Arthroscopic synovectomy, debridement, excisional biopsy and loose body removal combined with miniarthrotomy of the right elbow was performed due to limited exposure for removal of larger loose bodies. Histopathological examination of the tissue sample is consistent with the diagnosis of synovial osteochondromatosis. The clinical and radiological evaluation at 6th month postoperatively showed marked reduction in the volume of the elbow, further improvement of elbow range of motion of this patient and the Mayo elbow performance score before surgery and at 6 months postoperative, with an increase from 50 to 80 points. Synovial osteochondromatosis of the joints is a rare condition. The signs and symptoms are not specific and may be suggestive of other pathology conditions. Arthroscopic synovectomy and removal of loose body is the standard operative procedure till today. However, combination of arthroscopy and miniarthrotomy in cases of large loose bodies may provide a good clinical and functional outcome.
    Matched MeSH terms: Tomography, X-Ray Computed
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