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  1. Estimation of body height from spinal length measurements using post-mortem computed tomographic images
    Zyoud TYT, Abdul Rashid SN, Suppiah S, Mahmud R, Kabeer A, Abd Manaf R, et al.
    Malays J Pathol, 2020 Dec;42(3):423-431.
    PMID: 33361724
    INTRODUCTION: Post-mortem computed tomography (PMCT) provides information that helps in the determination of the cause of death and corpse identification of disaster victims. One of the methods for corpse identification includes assessment of the body stature. There is a lack of post-mortem imaging studies that focus on the anthropometric assessment of corpses. Our aim was to identify the relationship between cadaveric spine length and autopsy length (AL) among and autopsy length (AL) among a Malaysian population and derive a regression formula for the estimation of corpse body height using PMCT.

    MATERIALS AND METHODS: We retrospectively assessed 107 cadavers that had undergone conventional autopsy and PMCT. We made 5 measurements from the PMCT that included cervical length (CL), thoracic length (TL), lumbosacral length (LS), total column length of the spine, excluding the sacrum and coccyx (TCL), and ellipse line measurement of the whole spine, excluding the sacrum and coccyx (EL). We compared these anthropometric PMCT measurements with AL and correlated them using linear regression analysis.

    RESULTS: The results showed a significant linear relationship existed between TL and LS with AL, which was higher in comparison with the other parameters than the rest of the spine parameters. The linear regression formula derived was: 48.163 + 2.458 (TL) + 2.246 (LS).

    CONCLUSIONS: The linear regression formula derived from PMCT spine length parameters particularly thoracic and lumbar spine gave a finer correlation with autopsy body length and can be used for accurate estimation of cadaveric height. To the best of our knowledge, this is the first ever linear regression formula for cadaveric height assessment using only post mortem CT spine length measurements.

    Matched MeSH terms: Tomography, X-Ray Computed
  2. Fulltext Primary large B cell lymphoma of the parotid gland: case report
    Almothafar, B., Wong, L., Noorafidah, M.D.
    JUMMEC, 2011;14(1):26-30.
    MyJurnal
    Primary parotid lymphoma is uncommon and rarely suspected. In most cases, the disease would have disseminated at the time of diagnosis. We describe a case of primary non-Hodgkin’s lymphoma of the parotid gland which progressed to the central nervous system. Clinical history is of limited value in identifying this condition. Diagnostic imaging studies (CT or MRI) may indicate whether or not the mass is salivary in origin but do not help to confirm the diagnosis. In this case, it was deemed that FNA alone is incapable of determining the precise histological subtype for lymphoma, whilst a tru-cut biopsy demonstrated a more sensitive method of determining the diagnosis. The lessons learned from this case would prove useful for other health care providers to make an early diagnosis and hopefully manage more effectively if similar conditions appear in their practice. Performing the appropriate measures can help to not only improve the prognosis but may even avert the prospect of unnecessary surgery.
    Matched MeSH terms: Tomography, X-Ray Computed
  3. Fulltext Orbital rhabdomyosarcoma: a case series
    Chen, C.Y., Nor Hidayah, A.B., Adil, H.
    Malaysian Journal of Medicine and Health Sciences, 2013;9(2):69-72.
    MyJurnal
    In this paper, we report three cases of orbital rhabdomyosarcoma in different age groups with different histopathologic types. Case 1 is a 10-year old Malay boy who presented with painless proptosis of the left eye. Magnetic resonance imaging (MRI) showed soft tissue mass arising from the lateral rectus muscle. Tissue biopsy revealed rhabdomyosarcoma of embryonal type. Case 2 is a 32-year old Malay man who presented with a progressive left eye proptosis associated with pain and redness. Computed Tomography (CT) scan showed a retrobulbar mass extending medially in the left orbit. Meanwhile, biopsy showed rhabdomyosarcoma of pleomorphic type. Case 3 is a 67-year old Malay woman who presented with proptosis and fungating growth of left orbital region, epistaxis and nasal blockage. CT scan revealed an ill-defined mass filling up the left orbital cavity. Biopsy showed rhabdomyosarcoma of alveolar type. Rhabdomyosarcoma is the most common in childhood but it should be considered as a differential diagnosis of orbital tumours irrespective of age.
    Matched MeSH terms: Tomography, X-Ray Computed
  4. Fulltext A custom made phantom for dosimetric audit and quality assurance of three-dimensional conformal radiotherapy
    Radaideh, K.M., Matalqah, L.M., Tajuddin, A.A., Lee Luen, F.W., Bauk, S., Abdel Munem, E.M.E
    Jurnal Sains Nuklear Malaysia, 2012;24(1):0-0.
    MyJurnal
    The ultimate check of the actual dose delivered to a patient in radiotherapy can be achieved by using dosimetric measurements. The aims of this study were to develop and evaluate a custom handmade head and neck phantom for evaluation of Three-Dimensional Conformal Radiation Therapy (3D-CRT) dose planning and delivery. A phantom of head and neck region of a medium built male patient with nasopharyngeal cancer was constructed from Perspex material. Primary and secondary Planning Target Volume (PTV) and twelve Organs at Risk (OAR) were delineated using Treatment Planning System (TPS) guided by computed tomography printout transverse images. One hundred and seven (107) holes distributed among the organs were loaded with Rod-shaped Thermoluminescent dosimeters (LiF:Mg,Ti TLDs) after common and individual calibration. Head and neck phantom was imaged, planned and irradiated conformally (3D-CRT) by linear accelerator (LINAC Siemens Artiste). The planned predicted doses by TPS at PTV and OAR regions were obtained and compared with the TLD measured doses using the phantom. Repeated TLD measurements were reproducible with a percent standard deviation of < 3.5%. Moreover, the average of dose discrepancies between TLDs reading and TPS predicted doses were found to be < 5.3%. The phantom’s preliminary results have proved to be a valuable tool for 3D-CRT treatment dose verification.
    Matched MeSH terms: Tomography
  5. Fulltext Characterization of a gas-purge method to access 11C-carbondioxide radioactivity in blood
    Ng, Yen, Green Mark, A.
    Jurnal Sains Nuklear Malaysia, 2014;26(2):14-16.
    MyJurnal
    Carbon-11 labeled radiotracers, such as 11C-acetate and
    11C-palmitate are widely used in positron
    emission tomography (PET) for noninvasive evaluation of myocardial metabolism under varied
    physiological conditions.These tracers are attractive probes of tissue physiology, because they are
    simply radiolabled versions of the native biochemical substrates. One of the major metabolites
    generated by these tracers upon the administration is 11CO2 produced via the citric acid cycle. In
    quantitative modeling of
    11C-acetate and
    11C-palmitate PET data, the fraction of blood
    11C
    radioactivity present as
    11CO2 needs to be measured to obtain a correct radiotracer arterial
    input function. Accordingly, the literature describes a method whereby the total blood
    11C-activity
    is counted in blood samples treated with base solution, while the fraction of
    1 1CO2 is measured
    after the blood is treated with acid followed by a 10 minutes gas-purge. However, a detailed
    description of the experimental validation of this method was not provided. The goal of this study
    was to test the reliability of a 10 minute gas purging method used to assay
    11CO2 radioactivity in
    blood
    Matched MeSH terms: Tomography, X-Ray Computed
  6. A new system for classifying root and root canal morphology
    Ahmed HMA, Versiani MA, De-Deus G, Dummer PMH
    Int Endod J, 2017 Aug;50(8):761-770.
    PMID: 27578418 DOI: 10.1111/iej.12685
    Knowledge of root and root canal morphology is a prerequisite for effective nonsurgical and surgical endodontic treatments. The external and internal morphological features of roots are variable and complex, and several classifications have been proposed to define the various types of canal configurations that occur commonly. More recently, improvements in nondestructive digital image systems, such as cone-beam and micro-computed tomography, as well as the use of magnification in clinical practice, have increased the number of reports on complex root canal anatomy. Importantly, using these newer techniques, it has become apparent that it is not possible to classify many root canal configurations using the existing systems. The purpose of this article is to introduce a new classification system that can be adapted to categorize root and root canal configurations in an accurate, simple and reliable manner that can be used in research, clinical practice and training.
    Matched MeSH terms: Cone-Beam Computed Tomography
  7. Fulltext Ambiguous presentations of pulmonary epithelioid hemangioendothelioma: Two case reports of a rare pulmonary malignancy
    Soo CI, Ng BH, Tan EL, Abdul Hamid F
    SAGE Open Med Case Rep, 2016;4:2050313X16650323.
    PMID: 27489719 DOI: 10.1177/2050313X16650323
    Pulmonary epithelioid hemangioendothelioma is an uncommon lung malignancy of endothelial origin. Besides demonstrating unpredictable presentation features and prognosis, the paucity of established treatment guidelines remains a challenge in managing these patients. We present two patients. The first patient presented with chronic productive cough over 1-year duration. He was initially diagnosed and showed partial response to treatment for cardiac failure. A persistent right upper zone consolidation on chest radiograph prompted further investigations which revealed the diagnosis of pulmonary epithelioid hemangioendothelioma. The second patient presented with right-sided hemiparesis for 1-month duration. Initial computer tomography scan of the brain showed findings of distant metastatic foci. Subsequent investigations revealed pulmonary epithelioid hemangioendothelioma as the primary lesion. Both patients succumbed without any treatment due to rapid progression of the disease. We believe that pulmonary epithelioid hemangioendothelioma is undoubtedly rarely reported in south-east Asia region. In these two case reports, the patients were diagnosed in west and east Malaysia, respectively, in the same year (2015). Both cases highlight the increasing prevalence of pulmonary epithelioid hemangioendothelioma. We postulate that this could possibly be secondary to the advancement in diagnostic capabilities and improved healthcare facilities available in this region. Late presentation of pulmonary epithelioid hemangioendothelioma generally results in grave prognosis. Further investigations are required to elucidate the nature of progression and therapeutic options for patients with pulmonary epithelioid hemangioendothelioma.
    Matched MeSH terms: Tomography, X-Ray Computed
  8. Changes in rumen protozoal community by condensed tannin fractions of different molecular weights from a Leucaena leucocephala hybrid in vitro
    Saminathan M, Gan HM, Abdullah N, Wong CMVL, Ramiah SK, Tan HY, et al.
    J Appl Microbiol, 2017 Apr 23.
    PMID: 28434189 DOI: 10.1111/jam.13477
    AIMS: To evaluate the effects of condensed tannins (CTs) fractions of differing molecular weights (MWs) from a Leucaena leucocephala hybrid-Rendang on the rumen protozoal community in vitro.

    METHODS AND RESULTS: The effects of unfractionated CTs (F0) and CT fractions of different MWs (F1 > F2 > F3 > F4 > F5) on protozoal population and community were evaluated in vitro using rumen microbes and ground guinea grass as the substrate. Higher-MW CT fractions F1 and F2 significantly (P 

    Matched MeSH terms: Tomography, X-Ray Computed
  9. Nasopharyngeal Carcinoma with Cystic Cervical Metastasis Masquerading as Branchial Cleft Cyst: A Potential Pitfall in Diagnosis and Management
    Sai-Guan L, Min-Han K, Kah-Wai N, Mohamad-Yunus MR
    Iran J Otorhinolaryngol, 2017 Mar;29(91):117-120.
    PMID: 28393061
    INTRODUCTION: Most metastatic lymph nodes from head and neck malignancy are solid. Cystic nodes are found in 33% - 61% of carcinomas arise from Waldeyer's ring, of which only 1.8% - 8% originate are from the nasopharynx. Some cystic cervical metastases were initially presumed to be branchial cleft cyst. This case report aims to highlight the unusual presentation of cystic cervical metastasis secondary to nasopharyngeal carcinoma in a young adult. The histopathology, radiological features and management strategy were discussed.

    CASE REPORT: A 36-year-old man presented with a solitary cystic cervical swelling, initially diagnosed as branchial cleft cyst. Fine needle aspiration yielded 18 ml of straw-coloured fluid. During cytological examination no atypical cells were observed. Computed tomography of the neck showed a heterogeneous mass with multiseptation medial to the sternocleidomastoid muscle. Histopathological examination of the mass, post excision, revealed a metastatic lymph node. A suspicious mucosal lesion at the nasopharynx was detected after repeated thorough head and neck examinations and the biopsy result confirmed undifferentiated nasopharyngeal carcinoma.

    CONCLUSION: Cystic cervical metastasis may occur in young patients under 40 years. The primary tumour may not be obvious during initial presentation because it mimicks benign branchial cleft cyst clinically. Retrospective review of the computed tomography images revealed features that were not characteristic of simple branchial cleft cyst. The inadequacy of assessment and interpretation had lead to the error in diagnosis and subsequent management. Metastatic head and neck lesion must be considered in a young adult with a cystic neck mass.

    Matched MeSH terms: Tomography
  10. Fulltext Lateral thyroid cartilage thyrotomy approach to an embedded paraglottic fishbone
    Wong HT, Tham SY, Elangkumaran K, Ng W, Sia KJ
    Ann R Coll Surg Engl, 2017 Mar;99(3):e1-e2.
    PMID: 28071949 DOI: 10.1308/rcsann.2017.0010
    Fishbones are of particular interest to otolaryngologists. Most fishbones can be removed transorally or via endoscopic guidance. Transcervical neck exploration is occasionally necessary, especially in cases of an embedded foreign body. Computed tomography is the most sensitive and specific imaging modality for identifying embedded fishbones. To our knowledge, this is the first reported case of a laryngeal foreign body embedded in the paraglottic space that was removed using an open approach via a lateral thyroid cartilage window.
    Matched MeSH terms: Tomography, X-Ray Computed
  11. Fulltext Early Vessels Exploration of Pink Pulseless Hand in Gartland III Supracondylar Fracture Humerus in Children: Facts and Controversies
    Tunku-Naziha TZ, Wan-Yuhana W, Hadizie D, Muhammad-Paiman, Abdul-Nawfar S, Wan-Azman WS, et al.
    Malays Orthop J, 2017 Mar;11(1):12-17.
    PMID: 28435568 MyJurnal DOI: 10.5704/MOJ.1703.005
    The management of pink pulseless limbs in supracondylar fractures has remained controversial, especially with regards to the indication for exploration in a clinically well-perfused hand. We reviewed a series of seven patients who underwent surgical exploration of the brachial artery following supracondylar fracture. All patients had a non-palpable radial artery, which was confirmed by Doppler ultrasound. CT angiography revealed complete blockage of the artery with good collateral and distal run-off. Two patients were more complicated with peripheral nerve injuries, one median nerve and one ulnar nerve. Only one patient had persistent arterial constriction which required reverse saphenous graft. The brachial arteries were found to be compressed by fracture fragments, but were in continuity. The vessels were patent after the release of obstruction and the stabilization of the fracture. There was no transection of major nerves. The radial pulse was persistently present after 12 weeks, and the nerve activity returned to full function.
    Matched MeSH terms: Computed Tomography Angiography
  12. Epiploic Appendagitis: An uncommon surgical diagnosis
    Michael A, Zakry Y, Hanif H
    Med J Malaysia, 2017 04;72(2):128-129.
    PMID: 28473679 MyJurnal
    Epiploic appendagitis or appendices epiploicae, is a rare cause of abdominal pain in patients with mild signs of abdominal pathology. It mimics diverticulitis or appendicitis clinically as there are no pathognomonic features. It is a surgical diagnosis presenting with localised, sharp, acute abdominal pain, not associated with symptoms like nausea, vomiting, fever or suggestive laboratory values. With the availability of abdominal CT scans and ultrasound, it will frequently be a differential diagnosis preventing unnecessary surgery for patients. However, it may be erroneous and therefore clinical judgement is of paramount importance. This report highlights this rare presentation and identifies management guidelines.
    Matched MeSH terms: Tomography, X-Ray Computed
  13. Recurrent Endometrioid Adenocarcinoma of Endometrium With Bone Metastases
    Khoo ACH, Rashid NKA
    Clin Nucl Med, 2017 Aug;42(8):635-636.
    PMID: 28481802 DOI: 10.1097/RLU.0000000000001694
    Endometrial cancer, a common cancer affecting women, has the tendency to metastasize to the lung and liver. Bone metastases in endometrial cancers are rare and accounts for less than 1% of the overall incidence of metastases. We report a case of a 30-year-old single nulliparous woman with metastatic recurrence of endometrioid adenocarcinoma of the endometrium involving the pelvic bone, and the role of bone scintigraphy in detection and staging of the disease.
    Matched MeSH terms: Tomography, X-Ray Computed
  14. Fulltext Primary adenocarcinoma of the fallopian tube mimicking pelvic inflammatory disease
    Tamby, M.R., Juliana, M.B., Wan Hamilton, W.H., Masir, N., Hemlata, K.G.
    Medicine & Health, 2011;6(2):139-142.
    MyJurnal
    Primary fallopian tube carcinomas are rare and are difficult to diagnose preoperatively.
    We describe a fallopian tube carcinoma in a 50-year-old lady who presented with symptoms of pelvic inflammatory disease. Ultrasound examination showed bilateral hydrosalphinx. However, CT scan showed features suggestive of a malignant ovarian tumour. At surgery, a markedly dilated left fallopian tube was found and histopathological examination confirmed the presence of a primary serous adenocarcinoma. The uterus and both ovaries were free of tumour. This report highlights that carcinoma of the fallopian tube should be considered as a differential diagnosis in females who present with lower abdominal pain.
    Matched MeSH terms: Tomography, X-Ray Computed
  15. Fulltext A case of lymphangioleiomyomatosis with multiple angiomyolipomas in the kidneys: a case report
    How, S.H., Azlin, S., Pang, Y.K., Liam, C.K.
    JUMMEC, 2006;9(2):35-38.
    MyJurnal
    Lymphangioleiomyomatosis (LAM) is a rare disease. The reported prevalence is around one per million in the West but the exact prevalence in Asia is unknown. It affects primarily young women of reproductive age, with a mean age of onset at 34 years. The disease is characterised by an abnormal proliferation of smooth muscle-like cells that grow over a course of time to obstruct airways, lymphatic and blood vessels. We report a case of LAM in a young woman who presented with a spontaneous pneumothorax. Computed tomography scan of the thorax and abdomen showed homogenous thin-walled cystic lesions with normal intervening lung parenchyma and multiple lesions in her kidneys with Hounsfield units similar to that of fat.
    Matched MeSH terms: Tomography
  16. Fulltext Conversion Symptoms In Schizophrenia: A Case Report
    Ting, J.H., Nor Zuraida, Z., Sharmilla, K., Salina, M.
    Malaysian Journal of Psychiatry, 2009;18(2):1-5.
    MyJurnal
    We report a 35 year-old Iranian female who presented with a sudden onset of left sided hemiparesis associated with temporary loss of consciousness of about 3 minutes. Neurological examination revealed a power of 0/5 over the left upper/lower limbs but reflexes were normal and plantar reflex was downgoing and equivocal. A computed tomography scan was done and it revealed mild bilateral frontal atrophy and a temporal arachnoid cyst which was decidedly an incidental finding and it did not have any relation to the clinical presentation. Electroencephalogram and other laboratory findings were all normal. When the psychiatric team interviewed her, it was revealed that the patient had recently experienced a major stressful event just prior to the hemiparesis. On further interview, the patient had complained of delusions of persecution, delusions of reference and also auditory hallucinations for approximately a year prior to admission. There have been only a spatter of reports of conversion symptoms seen in patients with schizophrenia and this is such a case.
    Matched MeSH terms: Tomography
  17. Fulltext Evaluation of time-dependent pathways in an acute ischemic stroke protocol that incorporates CT perfusion: a tertiary referral center experience
    Hilwati, Hashim, Radhiana Hassan, Syazarina Sharis, Shahrul Azmin, Rabani Remli, Shahizon Azura Mukari, et al.
    Neurology Asia, 2013;18(4):355-360.
    MyJurnal
    Background and Objective: Intravenous thrombolysis service for stroke was introduced at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in 2009, based on the recommendations of a multidisciplinary team of clinicians. We report the experience at our center in establishing a stroke protocol incorporating computed tomography perfusion (CTP) of the brain, to assess the feasibility of incorporating CTP in the stroke protocol.
    Methods: A retrospective review of all patients who had a CTP between January 2010 and December 2011 was performed. Results: Of 272 patients who were admitted with acute ischemic stroke, 44 (16.2%) arrived within 4.5 hours from symptom onset and had a CTP performed with the intention to treat. The median time for symptom-to-door, symptom-to-scan and door-to-scan was 90.0 minutes (62.5 – 146.3), 211.0 minutes (165.5 – 273.5) and 85.0 minutes (48.0 – 144.8) respectively. Eight patients (2.9%) were thrombolysed of whom five received IV thrombolysis and three underwent mechanical thrombolysis. The median symptom-to-needle and door-to-needle times were 290.5 minutes (261.3 – 405.0) and 225.0 minutes (172.5 – 316.8) respectively. Four patients were thrombolysed despite being outside the window of treatment based on the CTP findings. Six of the thrombolysed patients had a Modified Rankin Score (MRS) of 1-2 at 5 months post procedure.
    Conclusions: CTP provides a benefit to management decisions and subsequent patient outcome. It is feasible to incorporate CTP as a standard imaging modality in a stroke protocol. The delays in the time-dependent pathways are due to our work flow and organisational process rather than performing the CTP per se.
    Matched MeSH terms: Tomography, X-Ray Computed
  18. Fulltext Cognitive impairments in mild traumatic brain injury and genetic polymorphism of apolipoprotein E: A preliminary study in a Level I trauma center
    Veeramuthu, Vigneswaran, Pancharatnam, Devaraj, Poovindran, Anada Raj, Nur Atikah Mustapha, Wong, Kum Thong, Mazlina Mazlan, et al.
    Neurology Asia, 2014;19(1):69-77.
    MyJurnal
    The complex pathophysiology of traumatic brain injury, its cascading effects and a varied outcome suggest that factors such as genetics may permeate and modulate the neurocognitive outcomes in patients with mild traumatic brain injury (mTBI). This study was conducted to determine the relationship between genetic polymorphism of apolipoprotein E, and neurocognitive and functional outcomes in mTBI. Twenty-one patients with mTBI were recruited prospectively. The severity of the injury was established with the Glasgow Coma Score (GCS). Other assessments included the CT Scan of the head on admission, Disability Rating Scale, Chessington Occupational Therapy Neurological Assessment (COTNAB) and Glasgow Outcome Scale (GOS). The Spearmen correlation analysis of ApoE allele status and the cognitive and functional assessments saw some association with the Sensory Motor Ability - Coordination (-0.526, p
    Matched MeSH terms: Tomography, X-Ray Computed
  19. Fulltext Management of renal cell carcinoma in von hippel-lindau syndrome: case report and review of literature
    Aroona, S., Shamsuddin, O.
    Journal of Surgical Academia, 2015;5(1):75-78.
    MyJurnal
    Renal cell carcinoma (RCC) is the one of the most common type of of cancer of the kidneys affecting adults. A 35- year-old man, with Von Hippel Lindau (VHL) syndrome was referred for bilateral renal mass in a follow up CT for evaluation. Open partial left nephrectomy was performed and the final histopathological report confirmed the diagnosis. One of the most important genetic and hereditary risk factor for RCC is Von Hippel-Lindau syndrome (VHL). RCC in VHL may occur bilaterally in some cases, so preserving renal parenchymal function is a major therapeutic goal and nephron sparing surgery provides a favorable patient outcome.
    Matched MeSH terms: Tomography, X-Ray Computed
  20. Fulltext Issues in management of acute appendicitis in pregnancy
    Nalliah, Sivalingam, Wijesuriya, Lionel, Venugopal, Subramani
    International e-Journal of Science, Medicine & Education, 2011;5(1):2-9.
    MyJurnal
    Acute appendicitis is an infrequent yet the commonest surgical emergency in pregnancy occurring in about 1:1500 pregnancies. The classical abdominal pain in the right lower quadrant of the abdomen is the only reliable clinical sign. Delay in diagnosis is attributed to presence of symptoms commonly seen in pregnancy like nausea and vomiting and difficulty in localizing abdominal pain due to displacement of the appendix with advancing gestation. Perforated appendix and generalized peritonitis impacts adversely on pregnancy contributing to increases in miscarriage, pre-term delivery, fetal loss and even maternal mortality. Imaging studies like abdominal ultrasonogram, helical computerized tomography and magnetic imaging have been utilized to complement clinical suspicion and decrease ‘negative appendectomies’ but robust data on their routine use is awaited. Although the laparoscopic approach is a useful diagnostic and therapeutic tool in early pregnancy, its use as the primary approach for appendicectomy in pregnancy requires further evaluation as increases in the incidence of fetal loss of 5.6% has been reported compared to 3.1% in open access surgery
    Matched MeSH terms: Tomography
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