• Title/Summary/Keyword: 흉부 X선 검사

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Entrance Skin Dose According to Age and Body Size for Pediatric Chest Radiography (소아 흉부촬영 시 나이와 체격에 따른 입사피부선량)

  • Shin, Gwi-Soon;Min, Ki-Yeul;Kim, Doo-Han;Lee, Kwang-Jae;Park, Ji-Hwan;Lee, Gui-Won
    • Journal of radiological science and technology
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    • v.33 no.4
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    • pp.327-334
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    • 2010
  • Exposure during childhood results in higher risk for certain detrimental cancers than exposure during adulthood. We measured entrance skin dose (ESD) under 7-year children undergoing chest imaging and compared the relationship between ESD and age, height, weight, chest thickness. Though it is important to measure chest thickness for setting up the exposure condition of chest examination, it is difficult to measure chest thickness of children. We set up exposure parameters according to age because chest thickness of children has correlation with age. In the exposure parameters, for chest A-P examination under 2 year-children, tube voltage (kVp) in hospital A was higher than that in hospital B while tube current (mAs) was higher in hospital B, thus the ESD values were about 1.7 times higher in hospital B. However, for chest P-A examination over 4 year-children, the tube voltage was 7 kVp higher in hospital B, the tube current were same in all two systems, and focus to image receptor distance (FID) in hospital B (180 cm) was longer than that in hospital A (130 cm), thus the ESD values were 1.4 times higher in hospital A. For same ages, the ESD values for chest A-P examinations were higher than those for chest P-A examinations. Comparing ESD according to age, ESD values were $154{\mu}Gy$, $194{\mu}Gy$ and $138{\mu}Gy$ for children under 1 year, 1 to under 4 years and 4 to under 7 years of age, respectively. These values were lower than reference level ($200{\mu}Gy$) recommended in JART (japan association of radiological technologists), however these were higher than reference values recommended by EC (european commission), NRPB (national radiological protection board) and NIFDS (national institute of food & drug safety evaluation). In conclusion, the values of ESD were affected by exposure parameters from radiographer's past experience more than x-ray system. ESD values for older children were not always higher than those for younger children. Therefore we need to establish our own DRLs (diagnostic reference levels) according to age of the children in order to optimize pediatric patient protection.

Surgical Treatment of Acute Necrotizing Klebsiella Pneumonia -Two cases report- (급성 괴사성 클렙시엘라 폐렴의 외과적 치료 -2례 보고-)

  • 류경민;김삼현;박성식;류재욱;최창휴;박재석;서필원
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.484-488
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    • 1999
  • Massive lung gangrene is a rare but very rapidly progressing fatal complication of lobar pneumonia. Etiologic agents are Klebsiella pneumoniae, Pneumococcus and Aspergillus, etc. Chest X-ray shows firm consolidation of the involved pulmonary lobe and bulging fissure due to the volume expansion of involved lung. CT-scan shows extensive lung parenchymal destructions with multiple small cavitary lesions. Recommended treatment is the early surgical intervention combined with antibiotics. Without surgical intervention, lung gangrene is known to progress toward sepsis, multiorgan failure, and high mortality. We report two cases of rapidly progressing massive lung gangrene by Klebsiella pneumonia treated by the resectional surgery.

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Effect of Human Implantable Medical Devices on Dose and Image Quality during Chest Radiography using Automatic Exposure Control (자동노출제어를 적용한 흉부 방사선 검사 시 인체 이식형 의료기기가 선량과 화질에 미치는 영향)

  • Kang-Min Lee
    • 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.

Estimated Exposure Dose and Usage of Radiological Examination of the National Health Screening (국가건강검진의 방사선검사 이용량 및 피폭선량 추정)

  • Gil, Jong Won;Park, Jong Hyock;Park, Min Hui;Park, Chan Young;Kim, So Young;Shin, Dong Wook;Kim, Won Dong
    • Journal of Radiation Protection and Research
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    • v.39 no.3
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    • pp.142-149
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    • 2014
  • Korea conducts a national health screening program to improve and check-up on public health and in recent years, the screening usage has been increased. Given the increased screening usage for radiographic exams, this study predicts the frequency of using radiographic exams and the exposure dose. This study estimates the usage of radiographic exams by isolating radiographic exams from the 2011 analysis of the national health insurance corporation, and estimates the public exposure dose by applying each procedure's dose table from UNSCEAR 2008. As a result of the analysis, in the 2011 National Health Screening, the average exposure dose per person is assumed to be 0.57 mSv, and depending on the type of screening program from the radiographic exam, an examinee could be exposed to between 0.2 mSv and 11.081 mSv. The frequency of using radiographic exposure was found to be 16,005,914 and the exposure dose was 6,311.76 person-Sv. The most frequent exam is the Chest X-ray, which was performed 1,070,567 (69.17%), and the UGI has the highest exposure dose at 5,217.94 person-Sv (82.67%). The outcome is categorized based on gender and age, excluding those under 39 years old. In all age groups, the screening usage and exposure dose are higher in females than in males. In particular, females between 50 and 54 years old have the highest screening usage (1,674,787, 10.5%) and exposure dose (701.59 person-Sv, 11.1%). As UGI accounts for 82.76% of procedures, except when done for medical purposes, if the government supports a voluntary UGI exam (which includes the UGI exam in the National Screening Program) or abolishes it completely, as seen overseas, the cost-effectiveness and validity of the UGI exam, as well as the exposure dose from the National Screening Program will all decrease significantly.

Pulmonary Giant Cell Carcinoma (폐에 발생한 거세포암종 -1 Case-)

  • 김현구;최영호;황재준;김욱진;김학제
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.185-188
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    • 1999
  • The pulmonary giant cell carcinoma is classified as a variant of a large cell carcinoma and is diagnosed by the minimum component of 10% huge, pleomorphic and multinucleated giant tumor cell and emperipolesis of the neutrophils into the tumor cells. This tumor is characterized by local recurrences and early metastasis with extremely short patient survival. However, there are some reports that state that the survival time was extended by the operative resection and postoperative adjuvant chemotherapy and radiotherapy. A 46-year old male was admitted with complaint of hemoptysis for 2 months. Through chest X-ray and chest CT, a 5cm sized mass was found in the apical segment of the right upper lobe. During the preoperative evaluation, stenotic lesion in the left anterior descending coronary artery was found and treated by percutaneous transarterial coronary angioplasty. Four weeks later, right upper lobectomy was performed and the mass was proven to be a giant cell carcinoma. The patient received adjuvant chemotherapy and radiotherapy.

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The clinical Characteristics of Mycoplasmal Pneumonia in Adults (성인 Mycoplasma 폐렴의 임상적 특성)

  • Kim, Jin-Ho;Moon, Doo-Seop;Lee, Dong-Suck;Park, Ik-Soo;Lee, Kyeung-Sang;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.175-183
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    • 1995
  • Background: The incidence of mycoplasmal pneumonia is predominantly at childhood and early adulthood, but in adults, its incidence is low and its symptoms and physical findings are nonspecific. The definite diagnosis of M. pneumoniae pneumonia can be made by sputum culture, but requires several weeks for positive results, and the early diagnosis must initially be based on the serologic tests and appropriate clinical findings. Thus, we evaluated the clinical aspects of M. pneumoniae pneumonia in the adults patients. Method: Among the admitted patients due to pneumonia, the definite diagnosis is anti-M. pneumoniae antibody titer of $\geq$ 1:40 and a single cold agglutinin titer of $\geq$ 1:64. The presumptive diagnosis is anti-M. pneumoniae antibody titer of $\geq$ 1:40 or a single cold agglutinin titer of $\geq$ 1:64 and the clinical characteristics or chest X-ray findings are compatible with M. pneumoniae pneumonia. We studied the age and sex distribution, seasonal distribution, clinical symptoms, physical findings, serologic test, chest X-ray findings, treatment and its progression. Results: 1) The age distribution was even and the ratio of male to female was 1:1. 2) The monthly distribution was most common in January(16.7%) and the seasonal distribution in autumn and winter(autumn: 30%, winter: 33.3%). 3) The cold agglutinin titers were higher than 1:64 in 12 cases(40%), and reached the peak level around 2 weeks from onset and antimycoplasma antibody titers were higher than 1:160 in 5 cases(16.7%). 4) On the chest X-ray, pulmonary infiltration was noted in 28 cases(93.3%) among 30 cases and right lower lobe involvement was the most common(33.3%) and both lower lobe involvement was noted in 7 cases(23.3%). 5) The mean treatment duration was most common(33.3%) in 1 week to 2 weeks after admission and 26 cases(86.7%) were improved within 4 weeks. 6) On admission, there was fever(${\geq}38.9^{\circ}C$) in 17 cases(56.7%), and the fever subsided in 12 cases(70%) within 3 days after treatment using erythromycin. Conclusion: The mycoplasmal pneumonia in adults shows milder clinical patterns than that in childhood and can be completely recovered without complication by early diagnosis and treatment.

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Middle Lobe Syndrome (중엽증후군)

  • 이용훈;김병철
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.621-625
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    • 1996
  • "Middle lobe syndrome" which was described y Graham and associates at first is always caused by ex- ternal bronchial compression by Iymph nodes. Although the patients may not present any symptom, the most common presenting symptoms were cough, dyspnea, fever, hemoptysis, and chest pain. Diagnostic procedures includ chest X-ray bronchoscopy, brochography, chest CT, and the principal finding is the contracted middle lobe which is usually airless. We experienced fifteen cases of middle lobe syndrome from April 1990 to May 1995. Eleven patients were treated surgically. The surgical candidates for middle lobe syndrome are suspicious malignancy, fixed bronchiectasis, bronchostenosis, intractable to medical treatment, recurrent infection. Operations were right middle lobectomy (8), right middle and lower bilobectomy (2), right upper and middle bilobectomy (1). Postoperative histological findings were tuberculosis in six, chronic inflammation in three, malignancy in one, and focal hemorrhage in one. There were two cases of postoperat ve complications which were postoperative atelectasis and hepatopathy.patopathy.

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Incidentally Detected Pericardial Defect in a Patient with Pneumothorax as Confirmed on Video-Assisted Thoracoscopic Surgery (흉강경 수술로 확인한 우연히 발견된 기흉을 동반한 심막결손)

  • Hyunwoo Cho;Eun-Ju Kang;Moon Sung Kim;Sangseok Jeong;Ki-Nam Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.749-755
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    • 2021
  • Congenital defects of the pericardium, which are generally asymptomatic, are rare disorders characterized by complete or partial absence of the pericardium. Here, we report a rare case of a 19-year-old male who was incidentally diagnosed with congenital absence of the left pericardium during examination for symptoms of pneumothorax. Chest radiography and CT revealed a collapsed left lung without any evidence of trauma, no unusual findings of free air spaces along the right side of the ascending aorta, heart shifted toward the left side of the thorax, and a shallow chest. Subsequent thoracoscopy confirmed the absence of the left pericardium and displacement of the heart toward the left thoracic cavity. We further discuss the correlation between radiologic images and surgical findings of a congenital pericardial defect associated with spontaneous pneumothorax.

A Study on the Relationship between the Aspect Ratio of Rt. Lung was Devided by Chest PA and Constitution, Body Composition and Questionnaire on the Differentiation of Syndromes (흉부 X선을 통한 우폐의 종횡비와 체질, 체성분분석 및 변증설문검사와의 상관성에 관한 연구)

  • Sin, Sun-Mi;Lee, Hyung-Kwon;Ko, Heung
    • The Journal of Internal Korean Medicine
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    • v.29 no.2
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    • pp.512-521
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    • 2008
  • Objective : The purpose of this study was to evaluate the Sasang constitution and body composition of the two groups devided by chest PA. Method : This study was carried out on 60 students of Semyung University. The students were selected according to the aspect ratio of rt. lung from chest PA. They were divided into two groups(length group and width group) and administered QSCCII & body composition analysis. Result : The 30 students of the length group were classified as Soumin(15), Soyangin(9), and Taeumin(6). The 30 students of the width group were classified as Taeumin(20), Soyangin(9), and Soumin(1). In the width group, weight, total body water, amount of total body fat, muscles, viceral fat area(VFA), waist hip ratio(WHR), were significantly higher than in the length group. Conclusion : There were significant relationships between the shape of lung and constitution and body composition. These findings indicate that actual organ condition could be expressed in body shape.

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Reduction of Exposure dose in Cheat Roentgenography (흉부X선검사(胸部X線檢査)에 있어서 피폭선량(被曝線量)의 경감(輕減)에 대한 검토(檢討))

  • Huh, Joon;Kim, Chang-Kyun;Kang, Hong-Seok
    • Journal of radiological science and technology
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    • v.2 no.1
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    • pp.15-22
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    • 1979
  • Author made a experiment on the exposure dose with various intensifying screens in taking chest roentgenogram and obtained the results as follows; 1. Special speed type was the most sensitive intensifying screen, the r(gamma) value of this screen was distributed from 2.6 to 2.9. 2. The resolution activity of intensifying screen was inversely proportional to its sensitivity. If, the sensitivity and detail of the fine detail speed type intensifying screen at 100 KV were 100, those of the special speed type were 549 and 54.44 respectively. 3. If the exposure dose of the fine detail type intensifying screen was 1.0 at 60 KV, that of the special speed type intensifying screen was 0.1 at 80KV, and the skin dose of patient was as follows; it was 64.8 mRad at 60KV in mid speed type, 8.1 mRad at 80KV in super high speed type, and 7.2 mRad at 80KV in special speed type intensifying screen respectively.

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