• The Korean Journal of Nuclear Medicine
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• v.39 no.4
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• pp.246-251
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• 2005

Purpose: There has been many reports for the effect of attenuation correction on myocardial perfusion SPECT. We studied the effect of attenuation correction with CT (computed tomography) in patients with normal coronary angiography. Materials and Methods: Fifteen patients with normal coronary artery on angiography and low likelihood of coronary artery disease were enrolled in this study (male: 6, female: 9, mean age: $58{\pm}8$ year). Myocardial perfusion SPECT was done with Millennium VG with Hawkeye device (GE, SPECT/CT camera). A visual analysis and polar map quantification (Emory tool box) was performed. In quantitative analysis, percent uptake of each myocardial wall on polar map (percent of maximal uptake) was compared between non-corrected (NC) and corrected (AC) images. Results: Visual analysis showed AC images led to an increase of uptake in the inferior wall, but decrease of uptake in the anterior wall, apex and septum. liver activity is also increased in AC images. In quantitative analysis, the percent uptake is decreased in the anterior wall, apex and septum, but increased in the inferior wall. It is helpful to interpret the images in the inferior wall after AC, but difficult in the apex and anterior wall after AC. Conclusion: AC is helpful in the inferior wall. But in the apex or anterior wall, AC must be carefully applied to normal perfused myocardium.

• Radiation Oncology Journal
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• v.29 no.2
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• pp.115-120
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• 2011

Purpose: To examine the feasibility of the treatment planning for minimizing carotid artery dose in the radiotherapy of early glottic cancer. Materials and Methods: From 2007 to 2010, computed tomography simulation images of 31 patients treated by radiotherapy for early glottic cancer were analyzed. The virtual planning was used to compare the parallel-opposing fields (POF) with the modified oblique fields (MOF) placed at angles to exclude the ipsilateral carotid arteries. Planning target volume (PTV), irradiated volume, carotid artery, and spinal cord were analyzed at a mean dose, $V_{35}$, $V_{40}$, $V_{50}$ and with a percent dose-volume. Results: The beam angles were arranged 25 degrees anteriorly in 23 patients and 30 degrees anteriorly in 8 dose-volume of carotid artery shows the significant difference (p<0.001). The mean doses of carotid artery were 38.5 Gy for POF and 26.3 Gy for MOF and the difference was statistically significant (p=0.012). Similarly, $V_{35}$, $V_{40}$, and $V_{50}$ also showed significant differences between POF and MOF. Conclusion: The modified oblique field was respected to prevent a carotid artery stenosis and reduce the incidence of a stroke based on these results.

• Progress in Medical Physics
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• v.11 no.1
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• pp.59-71
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• 2000

It is possible to obtain a fast CT scan during breath holding with spiral technique. But the risk of radiation is increased due to detailed and repeated scans. However, the limitation of X-ray doses is not fully specified on CT, yet. Therefore, the purpose of the present study is to define the limitation of X-ray doses on CT The CT unit was somatom plus 4. Alderson Rando phantom, Solenoid water phantom, TLD, and reader were used. For determining adequate position and size of organs, the measurement of distance(${\pm}$2mm) from the midline of vertebral body was performed in 40 women(20~40 years). On the brain scan for 8:8(8mm slice thickness, 8mm/sec movement velocity of the table) and 10:10(10mm slice thickness, 10mm/sec movement velocity of the table) methods, the absorption doses of exposed area of the 10:10 were slightly higher than those of 8:8. The doses of unexposed uterus were negligible on the brain scan for both 8:8 and 10:10. On the chest scan for 8:8, 8:10(8mm slice thickness, 10mm/sec movement velocity of the table), 10:10, 10:12(10mm slice thickness, 12mm/sec movement velocity of the table) and 10:15(10mm slice thickness, 15mm/sec movement velocity of the table) methods, 8:8 method of the absorption doses of exposure area was the most highest and 10:15 method was the most lowest. The absorption doses of 8:10 method was relatively lower than those of the other methods. In conclusion, the 8:10 method is the most suitable to give a low radiation burden to patient without distorting image quality.

• Childhood Kidney Diseases
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• v.9 no.2
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• pp.213-221
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• 2005

Purpose : Urachal anomalies are rare but are known to develop several complications, especially infection. Moreover, uniform guidelines for management have not been presented because of the variable clinical characteristics of these anomalies. The purpose of this report is to review our experience with urachal anomalies and attempt to determine the optimal management. Methods : We retrospectively reviewed the records of fourteen children with a variety of urachal anomalies who had been treated from January 1996 to June 2005 at Dong Kang General Hospital. Results : The age distribution of the patients(mean age; 3.8 years) was six neonates, one infant, five preschool-age and two school-age children. The male to female ratio was 1:1. Six cases of urachal cyst, four cases of patent urachus, two cases of urachal sinus and two cases of urachal diverticulum were found. Three patients with patent urachus and one with urachal cyst had hydronephrosis. Other associated anomalies included an inguinal hernia in one patient with urachal sinus and a vesicoureteral reflux in one patient with urachal diver ticulum. As a first-line diagnostic tool, high-resolution ultrasound examination was performed in thirteen cases and computed tomography in one case. Surgical excision was performed in nine patients with urachal anomaly. Five cases out of six neonatal cases experienced spontaneous improvement during a three-month follow up period. Due to frequent infection of the umbilicus, surgical excision was performed on one neonate with urachal sinus. Conclusion : All patients with urachal anomalies should undergo investigation for associated anomalies. The neonate with urachal anomalies, especially patent urachus, do not require surgical excision unless the patient has multiple episodes of recurrent infection. (J Korean Soc Pediatr Nephrol 2005;9:213-221)

• Journal of the Korean Society of Radiology
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• v.9 no.1
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• pp.9-16
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• 2015

The purpose of this study is finding optimum contrast medium quantity during abdominal CT using dual energy technique. The study subjects are 30 patients who had received general single energy abdominal CT and received double energy technique follow-up abdominal CT. dual energy technique abdominal CT images were obtained after setting contrast medium quantities at 30%, 40%, 50%, 60% and 70% of contrast medium quantity at the time of single energy technique. Then the contrast enhancement (Hounsfield Unit; HU) was estimated by setting-up the regions of interest at aorta, inferior vena cava, hepatic portal vein and hepatic parenchymal. The obtained values were compared to the values of the same parts measured during single energy technique abdominal CT. The results of the study were as following. The 60% set up group had HU in aorta : $210.80{\pm}13.609$, IVC : $190.40{\pm}25.215$, hepatic portal vein : $198.40{\pm}21.232$ and hepatic parenchymal : $119.20{\pm}7.98$, The single energy abdomianl CT images had HU in aorta : $205.40{\pm}16.426$, IVC : $188.20{\pm}21.476$, hepatic portal vein : $195.40{\pm}22.744$ and hepatic parenchymal : $121.00{\pm}6.595$. Therefore, it is possible to obtain contrast enhancement by dual energy technique abdominal CT similar to the same by single energy technique abdominal CT by setting-up the quantity of contrast medium at 60% of contrast medium at the time of single energy technique abdominal CT. Based on the result of this study, it is possible to decrease existing quantity of contrast medium by _% and the injection velocity can be also decreased. Accordingly, it is believed that the result of study would be quite useful for patients who have renal function disorder, weak vein or side effect of contrast medium in the past.

• Journal of the Korean Society of Radiology
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• v.12 no.3
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• pp.417-425
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• 2018

The psychological anxiety of radiologists, as well as the patients, is growing with the increasing use of CT contrast agent side effects and the process of extravasation. In this study, a satisfaction survey was conducted regarding the wireless signal device after CT examination in patients and radiologists by employing a wireless signal device during a contrast-enhanced CT examination in order to determine its usefulness to the relieve psychological anxiety, such as anxiety and fear, of patients and radiologists when using contrast agents. The use of a wireless signal device was also intended to help radiologists in dealing with the side effects of contrast agents that may occur during a CT examination and preventing extravasation. Patients aged 20 years or older, who visited the C university hospital in Jeonnam province for 4 months from August to November in 2017, were surveyed. A total number of 90 patients (57 males and 33 females),who agreed to the study after CT examination, were included in the questionnaire survey. Meanwhile, 15 radiologists, who were working at a CT room and had an experience in using a wireless signal device, were surveyed. Patient satisfaction was $6.01{\pm}0.88$ before the use of a wireless signal device and $8.20{\pm}1.06$ after use, thereby showing an increased satisfaction after its use. Radiologist satisfaction was $8.46{\pm}1.06$ after use, thereby not showing a big difference from the mean patient satisfaction. The satisfaction was high at over 8 points in both groups. The contribution to psychological stability with the use of a wireless signal device was $8.98{\pm}0.65$ in patients with prior experience of side effects and $8.00{\pm}1.21$ in patients without prior experience of side effects. In conclusion, it is considered to improve satisfaction with the examination by helping the radiologists in taking immediate action with calling via the wireless signal device and providing the patients and radiologists with psychological stability by reducing their anxiety.

• The Journal of Korean Society for Radiation Therapy
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• v.20 no.1
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• pp.37-43
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• 2008

Purpose: To evaluate dosimetry results of three different techniques for whole breast irradiation after conservative surgery of large pendulous breast patient. Materials and Methods: Planning computed tomography (CT) scans for three techniques were performed on a GE Hi-speed advantage CT scanner in the supine (SP), supine with breast supporting Device (SD) and prone position on a custom prone mattress (PP). Computed tomography images were acquired at 5 mm thickness. The clinical target volumes (CTV), ipsilateral lung and heart were delineated to evaluate the dose statistic, and all techniques were planned with the tangential photon beams (Pinnacle$^3$, Philips Medical System, USA). The prescribed dose was 50 Gy delivered in 25 fractions. To evaluate the dose coverage for CTV, we analysed percent volume of CTV receiving minimum of 95%, 100%, 105%, and 110% of prescription dose ($V_{95}$, $V_{100}$, $V_{105}$, and $V_{110}$) and minimal dose covering 95% ($D_{95}$) of CTV. The dosimetric comparison for heart and ipsilateral lung was analysed using the minimal dose covering 5% of each organs ($D_5$) and the volume that received >18 Gy for the heart and >20 Gy for the ipsilateral lung. Results: Target volume coverage ($V_{95}$ and $V_{100}$) was not significantly different for all technique. The V105 was lower for PP (1.2% vs. 4.4% for SP, 11.1% for SD). Minimal dose covering 95% ($D_{95}$) of target was 47.5 Gy, 47.7 Gy and 48 Gy for SP, SD and PP. The volume of ipsilateral lung received >20 Gy was 21.7%, 11.6% and 4.9% for SP, SD and PP. The volume of heart received >18 Gy was 17.0%, 16.1% and 9.8% for SP, SD and PP. Conclusion: Prone positioning of patient for large pendulous breast irradiation enables improving dose uniformity with minimal heart and lung doses.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.2
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• pp.98-103
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• 2010

Purpose: We reported the results of arthroscopically assisted lateral release and medial imbrication for the recurrent patella dislocation. Materials and Methods: Twenty patients (20 knees) underwent arthroscopically assisted surgery for the recurrent patella dislocation. There were 4 males and 16 female. The average age was 20.2 years. All patients had definite trauma history and average follow-up period was 19 months. The surgical results were evaluated according to the Lysholm knee score and the Kujala score. The congruence angle and lateral patellofemoral angle were measured on plain radiograph and the tibial tubercle-trochlear groove distance was calculated on computerized tomography. Results: The median value of preoperative congruence angle was $16.5^{\circ}$ (range, $0.0{\sim}+34^{\circ}$) and the average final follow-up was $-6.4^{\circ}$ (range, $-19{\sim}10^{\circ}$) with statistically significant improvement (p=0.025). The median value of preoperative Lysholm knee score was 70 (range, 63~81) and the final follow-up score had changed to 88 (range, 80~95) with statistically significant improvement (p=0.0341). The median value of preoperative Kujala score was 72 (range, 65~80) and the average final follow-up score showed 87 (range, 80~92) with statistically significant improvement (p=0.024). Recurrent dislocations after surgery occurred in 2 cases, one case which showed positive "thumb to forearm test" had been treated with medial patellofemoral ligament reconstruction. Conclusion: Arthroscopically assisted lateral release and medial imbrication for recurrent patella dislocation without bony malaligmenent showed the effective treatment, but would be inappropriate for the patients with the generalized joint laxity.

• Clinical and Experimental Pediatrics
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• v.46 no.8
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• pp.763-768
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• 2003

Purpose : This study was conducted to investigate the pulmonary cellular profiles and IL-8 levels in patients with post-measles wheezing. Methods : Twelve previously healthy infants with a minimum of three episodes of wheezing after measles pneumonia(Measles wheezing, median age, 1.3 years) were recruited by a retrospective examination of hospital records. They underwent bronchoalveolar lavage(BAL) with flexible bronchoscopy, and high-resolution computed tomography(HRCT) with a mean six(1-15) months interval. Comparisons were made with seven normal controls(Control, median age : 7.4 years). BAL cell counts and differentials were determined. IL-8 levels also were measured by ELISA. Results : The BAL cellular profiles were characterized by a significantly increased percentage of neutrophils in the Measles wheezing group(median 16.0%) compared to the control group(median 3.8 %)(P<0.01). IL-8 levels were markedly increased in the Measles wheezing group($mean{\pm}SD$, $512.7{\pm}324.0pg/mL$) compared to the control group($41.7{\pm}67.7pg/mL$)(P<0.01). Furthermore, IL-8 levels correlated significantly(r=0.816, P=0.001) with neutrophil percentages in BAL fluids in the Measles wheezing group. Abnormal HRCT findings were mosaic perfusion, bronchiectasis, bronchial wall thickening, and decreased vascularity. Conclusion : These results suggest that pulmonary neutrophils and IL-8 may play an important role in the pathogenesis of the post-measles wheezing.

• Korean Journal of Psychosomatic Medicine
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• v.20 no.2
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• pp.120-126
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• 2012

Objectives : The objective of this study is to measure and to compare the rate of depression, anxiety, self-es-teem and the quality of life of the patients with chest pain. Based on the result of this study, the necessity of the psychiatric assessment and treatment of the patients with chest pain is emphasized. This study is a preliminary research for a larger scale investigation to be carried out in the future. Methods : Thirty nine patients with chest pain who visited Cardiovascular Division of Dept. of Internal Medicine Pusan National University Hospital and fourty normal control group(NC) were included in this study. The patients were classified into typical chest pain group(TCP, N=19) and atypical chest pain group(ACP, N=20) based on the cause of the pain. The cause was determined by cardiac computed tomography, exercise stress test, coronary angiography, and questionaires by a cardiology specialist. The patients were assessed with Beck Depression Inventory(BDI), State-Trait Anxiety Inventory(STAI), Rosenberg Self-Esteem Scale(RSES) and Korean version of the Smith Klein Beecham 'Quality of Life' scale(KvSBQOL). Results : 1) When the risk factors of cardiac disease is compared, most of the factors(Hypertension, Diabetes, Hyperlipidemia, Cerebral infarction) did not differ significantly among the two chest pain groups, except for the family history, for which TCP group showed higher risk than ACP group did. 2) As for the self-report questionaires scores, BDI score, which indicates the rate of depression, of both ACP group and TCP group was significantly higher than that of NC group in BDI for depression. STAI score, which measures anxiety, was also significantly high in both groups. Especially, STAI score was significantly higher in ACP group than TCP group. 3) In the aspect of self-esteem and quality of life, ACP group scored significantly lower than TCP group and NC group. The scores for TCP group and NC group did not differ significantly. Conclusions : The patients with chest pain showed more depression and anxiety than normal control group, regardless of the cause of the pain. However, TCP group did not show significantly larger drop in self-esteem and quality of life than ACP group did. This result implies that early psychiatric assessment and treatment is needed for the patients with such chest pain, since it is highly likely that the pain would lead to lower quality of life of the patients.