• Journal of Trauma and Injury
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• v.33 no.4
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• pp.207-218
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• 2020

The following recommendations are presented herein: All trauma patients admitted to the resuscitation room should be constantly (or periodically) monitored for parameters such as blood pressure, heart rate, respiratory rate, oxygen saturation, body temperature, electrocardiography, Glasgow Coma Scale, and pupil reflex (1C). Chest AP and pelvic AP should be performed as the standard initial trauma series for severe trauma patients (1B). In patients with severe hemodynamically unstable trauma, it is recommended to perform extended focused assessment with sonography for trauma (eFAST) as an initial examination (1B). In hemodynamically stable trauma patients, eFAST can be considered as the initial examination (2B). For the diagnosis of suspected head trauma patients, brain computed tomography (CT) should be performed as an initial examination (1B). Cervical spine CT should be performed as an initial imaging test for patients with suspected cervical spine injury (1C). It is not necessary to perform chest CT as an initial examination in all patients with suspected chest injury, but in cases of suspected vascular injury in patients with thoracic or high-energy damage due to the mechanism of injury, chest CT can be considered for patients in a hemodynamically stable condition (2B). CT of the abdomen is recommended for patients suspected of abdominal trauma with stable vital signs (1B). CT of the abdomen should be considered for suspected pelvic trauma patients with stable vital signs (2B). Whole-body CT can be considered in patients with suspicion of severe trauma with stable vital signs (2B). Magnetic resonance imaging can be considered in hemodynamically stable trauma patients with suspected spinal cord injuries (2B).

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.2
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• pp.248-252
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• 2004

Wandering spleen is a rare condition characterized by migration of the spleen from its normal position due to laxity or absence of the supporting splenic ligaments. Ultrasonography shows the absence of the spleen in left upper quadrant (LUQ) and the presentation in the lower abdomen of a homognous mass whose sonographic appearance is consistent with that of a spleen. Contrast-enhanced CT reveals the absence of the spleen in LUQ, a soft tissue mass resembling spleen in the lower abdomen, and the splenic pedicle of whirled appearance. We present a case of wandering spleen, which could be diagnosed with US and CT by the ectopic location of spleen and the whirling pattern of splenic pedicle.

• Journal of Trauma and Injury
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• v.19 no.2
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• pp.135-142
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• 2006

Purpose: We planned to determine the diagnostic capability of focused assessment with sonography for trauma (FAST) in cases of blunt abdominal injury (BAI). Methods: A retrospective analysis of FAST sheets was performed from April 2002 to December 2004. During the study period, 135 BAI patients were evaluated with FAST at the Emergency Department of Bundang CHA Hospital. Of this group, twenty-eight patients were excluded, leaving 107 patients for analysis. Abdomen CT (computerized tomography) or exploratory laparotomy confirmed the presence of hemoperitoneum. At the secondary survey, patients underwent a three-view FAST examination (LogicQ; General Electric, Waukesha, USA) by an emergency physician, followed within 2 hours by an abdomen CT or exploratory laparotomy. The FAST examination was considered positive if it demonstrated evidence of free intra-abdominal fluid. Results: There were 45 true-positive FAST examination, 57 true-negatives, 1 false-positive, and 4 false negatives (sensitivity 91.8%, specificity 98.3%, positive predictive value 97.8%, negative predictive value 93.4%). The area under the ROC curve was 0.951 for the FAST examination. Conclusion: FAST is a highly reliable method for screening patients suspected of having BAI for the presence or absence of hemoperitoneum.

• Journal of Korean Medicine for Obesity Research
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• v.6 no.2
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• pp.75-83
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• 2006

Objectives : This study was performed to identify the effects of high frequency therapy on localized obesity. Methods : This trial was carried out in 12 volunteers. Volunteers were divided into 3 groups; upper arm group (n=4), thigh group (n=4) and abdomen group (n=4) according to local obesity type. Body weight and body fat were measured by Inbody 720 and CT (Computed Tomography) immediately before and following high frequency therapy. Diathermy was performed twice a week for 4 weeks for a total of 8 treatments. Results : In the upper arm group, body weight, body fat mass, fat area by CT scan and circumference were increased after treatment but not significantly (p>0.05). In the thigh group, body weight, body fat mass and circumference were decreased and fat area by CT scan was increased but both not significantly (p>0.05). In the abdomen group, significant differences were not found despite decreases in body weight, body fat mass, visceral fat and subcutaneous fat after diathermy (p>0.05). Conclusions : There was no significant effects of high frequency therapy on localized obesity.

• The Korean Journal of Food & Health Convergence
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• v.4 no.1
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• pp.23-31
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• 2018

The main issue of CT is radiation dose reduction to patient. The purpose of this study was to estimate the image quality and dose by iterative reconstruction (IR) for adults and pediatrics. Adult and pediatric images of phantom were obtained with 120 and 140 kV, respectively, in accordance with radiation dose in terms of volume CT dose index ($CTDI_{vol}$): 10, 15, 20, 25, 30, 35 mGy. Then, the adult and the pediatric images are reconstructed by filtered-backprojection (FBP) and iterative reconstruction (IR). The images were analyzed by signal-to-noise ratio (SNR). SNR is improved when IR and 140 kV are applied to acquire adult and pediatric images. In the adult abdomen, according to diagnostic reference level, the SNR values of bone were increased about 27.84 % and 27.77 % at 120 kV and 140 kV, and the tissue's SNR values of the IR were increased about 29.84 % and 33.46 % 120 and 140 kV, respectively. Dose is reduced to 40% in adults abdomen images when using IR reconstruction. In pediatric images, the bone's SNR were also increased about 17.70% and 18.17 % at 120 kV and 140 kV. The tissue's SNR were increased about 26.73 % and 26.15 % at 120 kV and 140 kV. Radiation dose is reduced from 30% to 50% for bone and tissue images. In the case of examinations for adult and pediatric CT, IR technique reduces radiation dose to patient, and it could be applied to adult and pediatric imaging.

• Journal of Trauma and Injury
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• v.22 no.1
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• pp.24-28
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• 2009

Purpose: This was conducted to assess the need for conventional radiographs of the thoracolumbar spine for routine screening of trauma patients who revealed no spinal trauma on chest and abdominal computed tomography (CT). Methods: We performed a retrospective review of the medical records of trauma patients who underwent conventional radiographs of the thoracolumbar spine following a chest and abdominal CT that revealed no spinal trauma. Results: Two hundred seventy-five trauma patients underwent conventional radiographs of the thoracolumbar spine following a chest and abdominal CT that revealed no spinal trauma. In 274 of the cases, the thoracolumbar spine series was also negative. Conclusion: CT of the chest and abdomen is an adequate evaluation of the thoracolumbar spine in trauma patients who require routine thoracolumbar spine screening, making subsequent conventional radiographs of the thoracolumbar spine unnecessary.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.3
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• pp.188-189
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• 2006

A 53-year -old man underwent $^{18}F$-FDG whole body PET/CT because of the detected liver mass on abdominal CT. The PET/CT showed a huge liver mass ($9{\times}9cm$, SUV: 12.12 ) in the right lobe and a focally hypermetabolic lesion in the right lower quadrant of abdomen (SUV: 9.12). At first, we suspected that the focal hypermetabolic lesion in RLQ was the physiologic uptake of ureter or a metastatic lesion of small bowel. We repeated the abdominal PET/CT next day. The focally hypermetabolic lesion was identified as the appendiceal mass. He underwent right hemicolectomy and right lobectomy of the liver. It was confirmed that the lesion was appendiceal adenocarcinoma with liver metastasis. Cancer of the appendix is an uncommon disease that is rarely suspected before surgery. But, we suggest that PET/CT is useful to identify the small lesion like appendiceal malignant mass.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.89-95
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• 2010

Purpose: Whole-body CT is a very attractive diagnostic tool to clinicians, especially, in trauma. It is generally accepted that trauma patients who are not alert require whole-body CT. However, in alert trauma patients, the usefulness is questionable. Methods: This study was a retrospective review of the medical records of 146 patients with blunt multiple trauma who underwent whole body CT scanning for a trauma workup from March 1, 2008 to February 28, 2009. We classified the patients into two groups by patients' mental status (alert group: 110 patients, not-alert group: 36 patients). In the alert group, we compared the patients' evidence of injury (present illness, physical examination, neurological examination) with the CT findings. Results: One hundred forty six(146) patients underwent whole-body CT. The mean age was $44.6{\pm}18.9$ years. One hundred four (104, 71.2%) were men, and the injury severity score was $14.0{\pm}10.38$. In the not-alert group, the ratios of abnormal CT findings were relatively high: head 23/36(63.9%), neck 3/6(50.0%), chest 16/36(44.4%) and abdomen 9/36(25%). In the alert group, patients with no evidence of injury were rare (head 1, chest 6 and abdomen 2). Nine(9) patients did not need any intervention or surgery. Conclusion: Whole-body CT has various disadvantages, such as radiation, contrast induced nephropathy and high medical costs. In multiple trauma patients, if they are alert and have no evidence of injury, they rarely have abnormal CT findings, and mostly do not need invasive treatment. Therefore, we should be cautious in performing whole-body CT in alert multiple trauma patients.

• Proceedings of the Korean Information Science Society Conference
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• 2005.11b
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• pp.886-888
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• 2005

본 논문에서는 복부 CT 영상에서 폐 부위를 빠르게 분할하기 위하여 그래픽 하드웨어를 사용한 레벨 셋 기법을 제안한다. 제안방법은 다음과 같이 세 단계로 구성된다. 첫째, 레벨 셋 기법을 그래픽 하드웨어로 효율적으로 구현하기 위하여 초기 레벨 셋 값 설정과 설정된 레벨 셋 값을 텍스처메모리에 저장한다. 둘째, 레벨 셋 기법의 가장 중요한 부분인 속도함수를 그래픽 하드웨어의 빠른 연산을 이용하여 계산하고, 레벨 셋 값을 갱신한다. 셋째, 갱신된 레벨 셋 값을 통하여 제로-레벨 셋을 찾는다. 본 논문에서는 제안 방법을 평가하기 위하여 일련의 복부 CT 영상을 사용하며, 육안평가 및 수행시간 면에서 기존 소프트웨어 기반 레벨 셋 기법과 비교분석한다. 실험결과 본 제안방법은 소프트웨어 기반 레벨 셋 기법과 분할결과를 동일하게 유지하면서 평균 9배 빠르게 폐 부위를 분할하였다.

• The Journal of Korean Society for Radiation Therapy
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• v.11 no.1
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• pp.100-105
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• 1999

Purpose : When the value of X,Y,Z coordination of the isocenter are reallocated from an arbitrary point using DRR (Digitally Reconstructed Radiographs) image in CT Simulation, conventional simulation is normally performed to verify the accuracy of this reallocation of the isocenter through the fluroscopy. The purpose of our experiment is to determine whether repeated test of the verification is necessary or not, and to analyze errors of reallocation with respect to the body region and the beam projection, if necessary, Material and Method : For 200 simulation patient, an arbitrary point is marked on each body and axial scaning is performed using CT, and treatment planing is done by drawing tumor and target volume on each slice. Using the planing data and the reallocated point of the isocenter, DRR image can be obtained and the final isocenter are marked on the patient's skin. In order to verify this reallocation of X,Y.Z coordination from CT simulation, We measure and evaluate the errors of these value on the fluoroscopy monitor and systematize them by classifying according to each body region (Brain, Neck and SCL, Lung, Esophagus, abdomen, Breast and Pelvis) and each beam projection {AP(PA), Supine, Prone and conformal : etc. } Conclusion : Isocenters are shifted by 3-5 mm in the case of Neck & SCL, Breast. at Abdomen, while noticeable differences are not found in other regions. Also, there are not correlations between the errors and the body regions or beam projections. However, our experiment intends to decide whether the procedure of verification is necessary on the vase of time and economy. It is regretful that we could not fully analyze the geometrical errors of DRR image and visual errors from the divergence. In conclusion, according to how much doctor consider tumor margin in drawing tumor and target volume, the meaning of analysis on the reallocation of isocenter should be reinterpreted, (which depends on the experience and capability of doctors)