• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.157-163
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• 2019

Purpose: To investigate the incidence and associated factors of delirium after orthopedic surgery. Materials and Methods: A total of 2,122 cases, who were older than 20 years and underwent orthopedic surgery at a single medical center during a one year period were included. Among them, 132 patients who were diagnosed with delirium after surgery under the Diagnostic and Statistical Manual of Mental Disorders-V criteria and medicated under the consultation of a psychiatrist were included in the study The differences in the incidence of delirium and several affecting factors were analyzed. Results: The overall incidence of delirium after surgery was 6.2% (132 in 2,122 cases). The mean age of the delirium group was 77.4 years (range, 54-92 years), which was higher than that of the non-delirium group (58.1 years). The percentage of women in the delirium group was 63.6% (84 in 132 cases), which was higher than that of the women in the non-delirium group (49.0%). The incidence of delirium after surgery was 9.3% (85 in 916 cases) due to trauma and 3.9% (47 in 1206 cases) due to disease. The incidence of postoperative delirium according to the surgical region was 29.2% (7 in 24 cases) in two or more regions, 13.7% (72 in 526 cases) in the hip, and 9.6% (14 in 146 cases) in the spine, 3.5% (20 in 577 cases) in the knee-lower leg, 2.5% (5 in 199 cases) in the foot-ankle, 2.4% (11 in 457 cases) in the shoulder-elbow, and 1.6% (3 in 189 cases) in the forearm-wrist-hand. Delirium occurred more rapidly in women and surgery due to disease, and the duration of delirium was longer in patients with dementia and major depressive disorders. Conclusion: The incidence of postoperative delirium was high in cases of surgery due to trauma and in cases of surgery in two or more sites. The incidence of postoperative delirium according to a single surgical region was higher in the order of the hip, spine, and knee. Active intervention is needed regarding the correctable risk factor.

• 한국노년학
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• v.30 no.4
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• pp.1293-1309
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• 2010

This study is aimed to evaluate the effects of community-based prehabilitation program developed to prevent functional decline in the frail elderly and to provide a basis to practically operate this program in the public health care service. From March to August 2009, 110 frail elderly people were recruited among the registered participants of the home visit program in Korea to perform a prospective randomized community trial. We randomly assigned these people into two groups. One group (n=50) participated in the visiting prehabilitation program for 3 months focusing on improving their muscle strength of upper and lower limbs, walking ability, and balancing. The other group (n=60) underwent our visiting fall prevention program for control. To assess the effectiveness of prehabilitation program, physical functioning (PF) and short physical performance battery (SPPB) were measured for the primary outcomes and also some other indicators: exercise performance, nutritional status, emotional functioning, experience of admission, and events of fall. As a result, significant improvements of geriatric functional status were noticed among the participants. After 3 months, PF increased by 1.3 ± 3.8 points in prehabilitation group and decreased by 1.1 ± 5.4 points in controls (p=.020). SPPB improved by 2.4 ± 2.0 points in prehabilitation group and increased only 0.3 ± 1.5 points in controls (p<.001). Significant effects were also shown in their exercise performance tests and emotional status, the number of multiple falls, and the experience of functional decline after the fall (p .002-.038). Visiting prehabilitation program is safe and effective program for frail older adults. Thus, it is strongly recommended to universally adopt this program to prevent functional decline in the frail elderly.

• Journal of the Korean Society of Radiology
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• v.17 no.6
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• pp.851-857
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• 2023

The purpose of this study is to investigate the effect of changes in collimation size and sub ROI on exposure index(EI) in hand radiography, present collimation size and EI suitable for average hand size of Koreans, and present the effect of changes in sub ROI on EI. The subjects of this study were hand-wrist phantom, and the exposure conditions were set to 55 kVp, 125, mA, and 6.25 mAs, and source to image receptor distance was applied to 110 cm. Based on the vendor recommended sub-ROI (18.7" × 18.7", 8" × 10", 8" × 7.4", 6" × 7.4")and the textbook's recommended sub-ROI 8" × 10", each obtaining 30 images, and comparing the EI shown in the equipment. The EI according to the change in the size of the collimation were 1663.7±4.52, 8"×10" is 1489.1±4.49, 8"×7.4" is 1716.9±3.00, 6"×7.4" is 168.7±3.66 for each EI, and the average value of each value was statistically significant. The average EI according to the sub ROI change was 1489.1±4.49 for SS, LS was 1694.8±5.19 for AEC, 2052.9±5.96, VR was 1548.3±3.20, and HR was 1663.2±4.33. The appropriate field size considering the hand size of Koreans was found to be 8"×7.4". In addition, when the field size increases based on the generally known field size (8"×10") during hand radiography, the EI value changes from a maximum of 15% to a minimum of 11%, and the sub ROI shape based on sub ROI 'SS' Depending on the change, the EI value increased from a maximum of 37% to a minimum of 3%.

• Journal of the Korean Society of Radiology
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• v.17 no.6
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• pp.903-909
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• 2023

The purpose of this study is to compare and analyze the effect of changes in the patient's central position on the exposure dose and image quality of surrounding organs during a chest lateral examination using an Auto Exposure Control(AEC). The experiment was conducted on a human body phantom. A needle was attached to the lower part of the center of the coronal plane of the phantom, and a lead ruler was attached to the lower part of the detector so that the 50 cm point was located at the lower center of the AEC ion chamber. The exposure conditions were 125 kVp, 320 mA, the distance between the source and the image receptor was 180 cm, and the exposure field size was 14 × 17 inches. Only one AEC ion chamber was used at the bottom center, and the density was set to '0' and sensitivity to 'Middle', and the central X-ray was incident vertically toward the 6th thoracic vertebra. With AEC mode applied, the 50 cm point of the needle and lead ruler were aligned and the phantom was moved 5 cm toward the stomach (F5) and 5 cm toward the back (B5), and the dose factor was analyzed by measuring ESD. The ESD of the thyroid gland according to the change in patient center position was 232.60±2.20 μGy for Center, 231.22±1.53 μGy for F5, and 184.37±1.19 μGy for B5, and the ESD of the breast was 288.54±3.03 μGy for Center, F5 was 260.97±1.93 μGy, B5 was 229.80±1.62 μGy, and the ESD of the center of the lung was 337.02±3.25 μGy for Center, F5 was 336.09±2.29 μGy, and B5 was 261.76±1.68 μGy. As a result of comparing the average values of dose factors between each group, the difference in average values was statistically significant (p<0.01), and each group appeared to be independent. As a result of the study, there was no significant difference in the dose to the thyroid, breast, and center of the lung according to the change in the patient's central position, except for the breast (10%) when the patient moved forward about 5 cm. However, movement of about 5 cm posteriorly resulted in an average dose reduction of 23.7%. Additionally, when the patient's central position was moved to the rear, image quality deteriorated.

• Journal of the Korean Society of Radiology
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• v.17 no.7
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• pp.1149-1155
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• 2023

This study aims to investigate the effect of changes in the Sub ROI on exposure index(EI) and to present indicators of changes in EI values that may occur when changing Sub ROI in clinical practice. This study was conducted on a subject of 20 cm of acrylic for a setting similar to abdominal radiography, and the specifications of one acrylic sheet is 20 × 20 × 5 cm. The survey conditions were the same as 80 kVp , 320 mA, 25 ms, SID 110 cm and the Sub ROI obtained 30 images for each type using five types provided by the equipment company. The EI value provided by the equipment and entrance skin exposure(ESE) were compared and analyzed. The mean value of EI according to the change in Sub ROI was 101.18±0.27 for LS, 106.57±0.31 for AEC, 107.74±0.39 for VR, 107.90±0.38 for HR, and 109.72±0.32 for SS (p<0.01). The average value of ESE by sub ROI type (LS, AEC, VR, HR, SS) was measured to be 476.45±1.71 μGy, 476.92±1.48 μGy, 476.14±2.30 μGy, 475.61±1.96 μGy, and 477.14±1.46 μGy, with statistically significant differences (p<0.01). As a result of this study, the EI according to the sub ROI type is based on LS(109.72), which represents the minimum value. AEC increased 5.3%, VR increased 6.4%, HR increased 6.6%, SS increased 8.4%, and overall, increased by about 5.3%. As for the average value of ESE, HR(475.61 μGy)type showed the minimum value, and based on this, AEC increased 0.27%, VR increased 0.11%, LS increased 0.17%, SS increased 0.32%, and overall, increased by about 0.17%.

• Journal of the Korean Society of Radiology
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• v.17 no.5
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• pp.767-773
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• 2023

To In this study, we sought to evaluate related factors affecting lung volume and their significance in pulmonary function and ventilation disorders. As experimental subjects, 206 normal adult men and women who underwent a low-dose chest CT scan and a spirometry test were selected at the same time. The experimental method was to measure lung volume using lung CT images obtained through a low-dose chest CT scan using deep learning-based AVIEW. Measurements were made using the LCS automatic diagnosis program. In addition, the results of measuring lung function were obtained using a spirometer, and gender and BMI were selected as related factors that affect lung volume, and significance was evaluated through an independent sample T-test with lung volume. As a result of the experiment, it was confirmed that in evaluating lung volume according to gender, all lung volumes of men were larger than all lung volumes of women. he result of an independent samples T-test using the respective average values for gender and lung volume showed that all lung volumes were larger in men than in women, which was significant (p<0.001). And in the evaluation of lung volume according to BMI index, it was confirmed that all lung volumes of adults with a BMI index of 24 or higher were larger than all lung volumes of adults with a BMI index of less than 24. However, the independent samples T-test using the respective average values for BMI index and lung volume did not show a significant result that all lung volumes were larger in BMI index 24 or higher than in BMI index less than 24 (p<0.055). In the evaluation of lung volume according to the presence or absence of pulmonary ventilation impairment, it was confirmed that all lung volumes of adults with normal pulmonary function ventilation were larger than all lung volumes of adults with pulmonary ventilation impairment. And as a result of the independent sample T-test using the respective average values for the presence or absence of pulmonary ventilation disorder and lung volume, the result was significant that all lung volumes were larger in adults with normal pulmonary function ventilation than in adults with pulmonary function ventilation disorder (p <0.001). Lung volume and spirometry test results are the most important indicators in evaluating lung health, and using these two indicators together to evaluate lung function is the most accurate evaluation method. Therefore, it is expected that this study will be used as basic data by presenting the average lung volume for adults with normal ventilation and adults with impaired lung function and ventilation in similar future studies on lung volume and vital capacity testing.

• Sim-seong Yeon-gu
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• v.33 no.2
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• pp.141-194
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• 2018

The article is about Yong-Ho-Bi-Gyeol(龍虎秘訣), which is one of the most important Taoist text in Korea written by Jeong-Ryum, a Taoist and alchemist in the Chosun Dynasty. The article deals with the alchemical and psychological meanings of Yong-Ho (龍虎, Dragon-Tiger), the way of nurturing cinnabar (修丹之道), the closing of the qi (閉氣), the method of alchemical breathing, the Dantian (丹田, cinnabar-field), and the Mysterious Female's One Opening (玄牝一竅), in addition to the brief introduction of the life of Jeong-Ryum and the bibliography of the book. The Yong-Ho (龍虎) meaning the dragon and tiger is the archetype of transformation in the form of their opposites, rooted in the psychoid system of the human psyche. The unified Yong-Ho makes Dan and the Dan, literally indicating cinnabar, has many alchemical connotations such as Mercurius, the rubedo state of the alchemical process, and the philosopher's stone. In the book, Jeong-Ryum emphasized the slow and subtle way of breathing in and out of Dantian to develop neidan (内丹, inner cinnabar or inner alchemy). The refining of neidan begins by the closing of the qi, which symbolizes the radical introversion and withdrawal of all the projections on the outer objects. The Dantian located at the lower part of the abdomen has been known to preserve jing (精), the vital essence of life, which can be refined into qi and spirit (神). In Jungian perspective, the Dantian is a mandala where an individual's mind can stay and focus at the center of psyche detached from ego and related to the Self. The long-nurtured introverted energy makes the Mysterious Female's One Opening (玄牝一竅), a pit or cavity in the transcendental space, through which the meditator can have a relationship with the great female principle of the universe. The current article has introduced the contents of the Yong-Ho-Bi-Gyeol in the perspective of analytical psychology. However, it has not dealth with the remaining topics including Taesik (胎息, embryonic breathing) and Juchenhwahu (周天火候, the great Celestial circuit firing), due to the lack of author's sufficient knowledge and experience. The unexplored areas of Yong-Ho-Bi-Gyeol will be studied in the future.

• Journal of the Korean Society of Radiology
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• v.18 no.1
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• pp.45-52
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• 2024

In this study, an AI-based algorithm was developed to prevent image quality deterioration and reading errors due to patient movement in PET/CT examinations that use radioisotopes in medical institutions to test cancer and other diseases. Using the Mothion Free software developed using, we checked the degree of correction of movement due to breathing, evaluated its usefulness, and conducted a study for clinical application. The experimental method was to use an RPM Phantom to inject the radioisotope 18F-FDG into a vacuum vial and a sphere of a NEMA IEC body Phantom of different sizes, and to produce images by directing the movement of the radioisotope into a moving lesion during respiration. The vacuum vial had different degrees of movement at different positions, and the spheres of the NEMA IEC body Phantom of different sizes produced different sizes of lesions. Through the acquired images, the lesion volume, maximum SUV, and average SUV were each measured to quantitatively evaluate the degree of motion correction by Motion Free. The average SUV of vacuum vial A, with a large degree of movement, was reduced by 23.36 %, and the error rate of vacuum vial B, with a small degree of movement, was reduced by 29.3 %. The average SUV error rate at the sphere 37mm and 22mm of the NEMA IEC body Phantom was reduced by 29.3 % and 26.51 %, respectively. The average error rate of the four measurements from which the error rate was calculated decreased by 30.03 %, indicating a more accurate average SUV value. In this study, only two-dimensional movements could be produced, so in order to obtain more accurate data, a Phantom that can embody the actual breathing movement of the human body was used, and if the diversity of the range of movement was configured, a more accurate evaluation of usability could be made.

• Journal of the Korean Society of Radiology
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• v.18 no.3
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• pp.257-265
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• 2024

In this study, we applied AEC(Auto Exposure Control), which is used in many chest examinations, to evaluate whether medical devices inserted into the body affect the dose and image quality of chest images. After attaching three HIMD(Human implantable medical devices) to the ion chamber, the Monte Carlo methodology-based program PCXMC(PC Program for X-ray Monte Carlo) 2.0 was applied to measure the effective dose by inputting the DAP(Dose Ares Product) value derived from the Pacemaker and CRT and Chemoport Additionally, to evaluate image quality, we set three regions of interest and one noise region on the chest and measured SNR and CNR. The final study results showed significant differences in DAP and Effective dose. There was a significant difference between Pacemaker and CRT when AEC was applied and not applied. (p<0.05) When applied, the dose increased by 37% for Pacemaekr and 52% for CRT. Chemoport showed a 10% increase in effective dose depending on whether AEC was applied, but there was no significant difference. (p>0.05) In the image quality evaluation, there was no significant difference in image quality between all HIMD insertions and AEC applied or not. (p>0.05) Therefore, when the HIMD was inserted into the chest during a chest x ray and overlapped with the ion chamber sensor, the effective dose increased, and there was no difference in image quality even at a low dose without AEC. Therefore, when performing a chest X-ray examination of a patient with a HIMD inserted, it is considered that performing the examination without applying AEC is a method that can be considered to reduce the patient's radiation exposure.

• Sim-seong Yeon-gu
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• v.28 no.1
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• pp.50-87
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• 2013

C. G. Jung believed that universal and basic condition of human's Unconscious comes out from Märchen or mythology. We can easily experience these universality of human nature in dreams. Therefore, It is very important to interpret mythogens that appear in myths and märchen in analytical psychology to understand these 'big dreams' which could be seen in clinical practice. As I was interested in interpreting myths in analytic psychology, I tried to find universality of archetypes in Korea's traditional folk tales and took note of the birth myth of Hyeokgeose, the founder of Shilla dynasty, while examining the chater of the Unsual in history in the Heritage of the Three Kingdoms. Shilla was founded earlier than two other countries, but it was located in the very south of the Korean Peninsula, and it was behind times in politically, militarily, and culturally compare to Goguryeo and Baekje. However, Shilla achieved unifying the Three Kingdoms and it lasted 1000 years, the longest unified history in Korean history. I tried to examine archetypes in the birth myth if there are any backgrounds that are related to finding a Shilla Kingdom. It is noted that myth of the founder of Korean Peninsula's small Kingdom Shilla has complete story from before the birth to birth, birth of spouse, growth, marriage, accession, governing, death, after death, and succession. Symbols such as numbers 1, 3, 5, 6, 7, 13 and 61, various azimuthes including north, west, south, east, and central, animals like tiger, white horse, hen, dragon, phoenix, and snakes, natures like main symbol egg, rock, gourd, lightening, spring water, stream, tree, forest, mountain, iron and goddess-image like seon-do Holy Mother gradually appears in the myth. These symbols could show a meaning of human experience such as birth of Conscious, growth and development of paternal and maternal love, and story of regeneration and extinction. Moreover, It could be seen as these progress eternally continues in next generation. I have found out that a word, a sentence or stories that looks meaningless in myth revealed its true symbolical meaning. In addition, interaction between Unconscious and Conscious repeats in different forms, and expressed in layered.