• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.56-62
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• 2005

Because of high morbidity and mortality, traumatic diaphragm injury remains a diagnostic challenge. In this study, we evaluate that some factors and scores can be used as predictors. Material and Method: From May 1995 to June 2003, 23 patients with traumatic diaphragm injury were enrolled. We examined the clinical features of patients. RTS, TRISS, ISS and APACHE II scores for each patient are calculated for analyzing the relationship of mortality and ICU duration. Result: The study identified 15 men $(65.2{\%})$ and 8women $(34.8{\%})$. There are right sided diaphragmatic injury in 11 patients $(47.8{\%})$, left sided in 11 $(47.8{\%})$, and both sided in 1 ($0.4{\%}$). Plain X-ray, CT, upper GI contrast study and esophagogastroscopy were used as diagnostic tools. Age, hemodynamic status, early diagnosis are not associated with outcome. As prognostic factor, RTS and ISS are associated with mortality and there was negative relationship between RTS and ICU duration (r=0.737, p=0.026). Conclusion: An early diagnosis of traumatic diaphragm injury can frequently be missed in the acute trauma setting. So high index of suspicion and a careful examination are important in multiple trauma patients. An RTS can probably be used effectively as a predictor for the severity and prognosis in patients with traumatic diaphragm injury.

• Journal of Chest Surgery
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• v.37 no.7
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• pp.585-590
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• 2004

Bronchogenic cyst is a rare and benign disease. Because of its complication or associated disease, Bronchogenic cyst requires surgical treatment. Recently, with the development of diagnostic methods, its incidence has increased. So we reviewed our results from the past 30 years. Material and Method: We reviewed 27 cases surgically treated from March 1971 to March 2003. This investigation is designed to illustrate the peak age incidence, sex ratio, symptoms, anatomic location, radiologic imagings, associated diseases, operative methods, postoperative pathologic findings and postoperative complications. Result: The peak age incidence laid in the 1st to 3rd decade and the ratio of male and female was 1 : 1.5. The most common complaints were cough and dyspnea, but some had hemoptysis. There were 22 cases (81%) of Intrapulmonary bronchogenic cysts and 5 cases(19%) of mediastinal bronchogenic cysts. Thirteen cases (48.1%) showed cystic lesion in simple chest X-ray. Ten cases showed cystic lesion among 13 cases that had taken computed tomography. We found associated disease in 15cases (56%). The inflammatory diseases from infection were many in intrapulmonary bronchogenic cysts and especially, one case showed carcinosarcoma. Mitral regurgitation and Bronchial obstruction could be seen in mediastinal bronchogenic cysts. The 13 cases (48%) were managed by lobectomy, and cystectomy, pneumonectomy, and segemental resection were done in 7 cases (26%), 4 cases (15%), 3 cases (11%) respectively. Cystic contents were mucus in 9 cases, pus in 9 cases, blood in 2 cases, and carcinosarcoma in 1 case. Bronchotracheal communications were in 13 cases (48%). Five cases showed Postoperative complications, which were pneumothorax, empyema, bleeding. Postoperative death could not be found. Conclusion: Almost all patients had clinical symptoms. Severe complications could be associated with bronchogenic cysts. Recently, With the development of diagnostic methods, preoperatively accurate diagnosis is possible; therefore, invasive study has decreased. Bronchogenic cyst is a benign disease. However, because of its clinical symptoms, complications, and possibility of malignant change, immediate surgical treatment is needed.

• Journal of Chest Surgery
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• v.34 no.7
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• pp.534-538
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• 2001

Background: Knowledge of size and morphology of the normal trachea is important for airway management and tracheal reconstruction. Conventional radiography is a simple method used to measure the tracheal diameter, but it is not accurate because of the artifacts related to image magnification and overlapping by the shoulder. The purpose of this study was to provide the normal values of the tracheal size and anatomy in Korean adults using Computerized Topography. Material and Method: There were 43 men and 34 women included in this study. They were divided into three age groups(group 1, 20-39 years ; group 2, 40-59 yeas , groups 3, $\geq$60 years). The anteroposterior and transverse diameters and cross - sectional areas of the trachea were measured at the level of the thoracic inlet(Level 1) and the aortic arch(Level 2). These values obtained at each level were compared between age groups and sexes. Result: In 43 men, the anteroposterior / transverse diameters(mean SD in millimeters) of the trachea at levels 1 and 2 were 19.95$\pm$2.99 / 17.72$\pm$2.13 and 19.77$\pm$2.57 / 18.02$\pm$2.19, respectively. In 34 women, those values at levels 1 and 2 were 15.56$\pm$2.12 / 14.18$\pm$2.07 and 15.35$\pm$1.82 / 15.00$\pm$1.60, respectively. At both levels, the anteroposterior and transverse diameters were significantly greater in men than in women (p<0.05). The cross-sectional area of the trachea at levels 1 and 2 were 279.14$\pm$61.37 / 281.93$\pm$63.97 $\textrm{mm}^2$ in men and 173.29$\pm$35.81 / 181.88$\pm$34.74 in women, respectively. They also showed significantly greater values in men than in women(P<0.05). There was no significant difference in diameters and cross-sectional areas of the trachea between age groups. Conclusion: There are significant differences in the internal diameter and cross- sectional area of the trachea between men and women in normal Korean adults, while the age difference was insignificant. We believed CT is a relatively accurate and safe way to measure the internal diameter and cross-sectional areas of the trachea.

• Tuberculosis and Respiratory Diseases
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• v.66 no.1
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• pp.13-19
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• 2009

Background: The interferon-gamma assay is reported to have high sensitivity and specificity for making the diagnosis of latent tuberculosis infection. The clinical usefulness of this essay for detecting active tuberculosis has not fully defined. We evaluated the diagnostic value of the commercial interferon-gamma assay kit (QuantiFERONTB GOLD) for patients with suspected tuberculosis. Methods: From January to August 2007, we recruited 52 patients with suspected tuberculosis infection. We performed chest X-ray, sputum smear, culture, PCR and the QuantiFERON-TB GOLD test. Pleural fluid analysis and pleural biopsy were also done for the patients with pleural effusion. Results: Of the 52 patients we studied, 30 patients had a positive QuantiFERON-TB GOLD test result. 35 patients were finally diagnosed with active tuberculosis: twenty-five with a positive QuantiFERON-TB GOLD test and 10 with a negative QuantiFERON-TB GOLD test. The sensitivity of the QuantiFERON-TB GOLD test was 71.4% and the specificity was 64.7%. The positive predictive value was 0.83 and the negative predictive value was 0.50. There was no significant difference of any of the clinical and laboratory characteristics between the two groups of patients except the C-reactive protein (CRP) level. The CRP level was 29.2${\pm}$27.3 mg/dL in the pulmonary tuberculosis patients with a positive QuantiFERON-TB GOLD test and 72.9${\pm}$67.9 mg/dL in the patients with a negative QuantiFERON-TB GOLD test (p<0.05). Conclusion: The sensitivity and specificity of the QuantiFERON-TB GOLD test were inadequate for making the diagnosis of active tuberculosis. We suggest that the QuantiFERON-TB GOLD test should not be used by itself to exclude the diagnosis of active tuberculosis. The relationship of the QuantiFERON-TB GOLD test and the CRP level in patients with TB would be further investigated.

• Progress in Medical Physics
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• v.16 no.1
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• pp.10-15
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• 2005

IAEA's guidance levels have been provided for western people to the end. Guidance levels lower than the IAEA'S will be necessary in view of Korean people's proportions. Therefore, we need to develope the standard doses for Korean people. And we conducted a nationwide survey of patient dose from x-ray examinations in Korea. In this study, the 278 institutions were selected from Members Book of Korean Hospital Association. The valid response rate was approximately 57.9%. Doses were calculated from the questionnaires by NDD method. We obtained the results were as follows; 1) General radiographic equipments were distributed for 42.0%, fluoroscopic equipments 29.4%, dental equipments 13.2%, CT units 8.1 % and mamographic units 7.2%. 2) According to classification by rectification, three-phase equipments were 29.9%, inverter-type generators 29.5%, single-phase equipments 25.5%, constant voltage units 9.0% and unknown units 6.0%. 3) According to classification by receptor system, film-screen types were 46.8%, CR types 26.8%, DR types 17.7% and unknown types 8.9%. 4) The number of examinations were chest 49.2%, spine 16.8% and abdomen 12.7%. 5) Patient doses were head AP 3.44 mGy, abdomen AP 4.25 mGy and chest PA 0.39 mGy.

• Progress in Medical Physics
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• v.23 no.1
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• pp.26-32
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• 2012

The magnification technique has recently become popular in bone radiography, mammography and other diagnostic examination. However, because of the finite size of X-ray focal spot, the magnification influences various imaging properties with resolution, noise and contrast. The purpose of study is to investigate the influence of magnification and focal spot size on digital imaging system using eDQE (effective detective quantum efficiency). Effective DQE is a metric reflecting overall system response including focal spot blur, magnification, scatter and grid response. The adult chest phantom employed in the Food and Drug Administration (FDA) was used to derive eDQE from eMTF (effective modulation transfer function), eNPS (effective noise power spectrum), scatter fraction and transmission fraction. According to results, spatial frequencies that eMTF is 10% with the magnification factor of 1.2, 1.4, 1.6, 1.8 and 2.0 are 2.76, 2.21, 1.78, 1.49 and 1.26 lp/mm respectively using small focal spot. The spatial frequencies that eMTF is 10% with the magnification factor of 1.2, 1.4, 1.6, 1.8 and 2.0 are 2.21, 1.66, 1.25, 0.93 and 0.73 lp/mm respectively using large focal spot. The eMTFs and eDQEs decreases with increasing magnification factor. Although there are no significant differences with focal spot size on eDQE (0), the eDQEs drops more sharply with large focal spot than small focal spot. The magnification imaging can enlarge the small size lesion and improve the contrast due to decrease of effective noise and scatter with air-gap effect. The enlargement of the image size can be helpful for visual detection of small image. However, focal spot blurring caused by finite size of focal spot shows more significant impact on spatial resolution than the improvement of other metrics resulted by magnification effect. Based on these results, appropriate magnification factor and focal spot size should be established to perform magnification imaging with digital radiography system.

• 한국해양학회지
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• v.24 no.3
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• pp.132-147
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• 1989

A total of 83 surface sediments and 55 sea water samples, collected from the southwestern sea of Cheju Island, were analyzed in order to understand their textural characteristics, geochemical composition and the clay mineralogical features. The sediments were subdivided into ten textural classes, namely clayey sand, slightly gravelly muddy sand, sandy clay, clay and mud. The coarse and fine-grained mixed sediments are distributed in the northern part and around the Island, whereas the fine-grained deposits are mainly distributed in the central and southern parts of the study area; small scale mud patches are distributed in the southwestern and northern parts of Cheju Island. The high concentration of total suspended matter in study area gradually increase toward the southwestern and northwestern offshore area. The concentration of geochemical elements is as follow: the content of Mn, Al, Zn, Cr, Cu and Sn increase toward the southern part which is covered mainly with fine-grained deoposits, whereas the content of Ca, Mg and Ag is higher in the northern area; the elements such as Ni, Na, Fe and Pb are more concentrated relatively in muddy deposits rather than in sandy sediments. The light minerals such as Na-Ca feldspars show a high content around the Socotra Rock, toward the Soheugsan and Cheju Islands, but the K-feldspars are relatively high around the Cheju Island. It was noticed that the provenance of these sediments is partly influenced by the geological characteristics near the island. X-ray diffractogram for clay minerals from the southeastern mud patch and around the Soheugsan Island shows the diagnostic calcite peak indicating that the greater part of these clay fraction may have been derived from present and ancient Hwangho River. The high concentration of smectite in the northern part near the Cheju and around the Soheugsan Islands, eastern side of Socotra Rock probably result from supplies smectite altered from volcanic materials distributed in the Cheju Island and Socotra Rock, whereas the samples near the Chuja and northern parts of the Cheju Island contain weak calcite peak and high concentration of kaolinite and chlorite which is closely related to the geolgical characteristics on the adjacenting land area.

• Journal of Chest Surgery
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• v.36 no.7
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• pp.497-503
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• 2003

Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

• Journal of radiological science and technology
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• v.30 no.1
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• pp.25-32
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• 2007

This study is to evaluate the factors that affect to the bone mineral density(BMD) of postpartum women by comparing BMD between postpartum and general women who are ages from 20 to 39, and to identify correlation between various factors weight, height, body mass index(BMI), hemoglobin(Hb) and BMD. Study subjects were postpartum(n=159) and general(n=180) women. We checked the BMD of femoral neck and lumbar spine by using dual energy X-ray bone densitometry. The mean age was $30.69{\pm}3.32$ in postpartum care group and $31.22{\pm}5.66$ in general women group. In postpartum care group, the mean BMD of femoral neck and lumbar spine were -0.187 and -0.076. In general women group, the mean BMD of femoral neck and lumbar spine were -0.029, and -0.169. According to BMI level, each group was divided into two subgroups. One was 23 or more BMI subgroup, and the other was under 23 BMI subgroup. There was a significant difference in BMD of femoral neck and lumbar spine between two subgroups in general women group, but only a significant difference in BMD of lumbar spine is noted between two subgroups of postpartum group. According to Hb level, each group was divided into two subgroups. One was 11g/dl or more subgroup, and the other was under 11g/dl subgroup. There was not a statistically significant difference of BMD in all subgroups. BMD of femoral neck and lumbar spine showed a significant correlation with weight, height, BMI in both groups. There was a significant correlation between BMD and Hb level in postpartum care group, but a significant correlation was not noted in general women group. The postpartum women showed a significant correlation between BMD and various factors such as weight, height, BMI just like in general women. There was a significant correlation between BMD and Hb in postpartum women, but not in general women.

• Progress in Medical Physics
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• v.17 no.3
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• pp.173-178
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• 2006

The purpose of this study was to evaluate the radiation dose for clinical PET/CT protocols in clinical environments using Alderson phantom and TLDs. Radiation doses were evaluated for both Philips GEMINI 16 slice PET/CT system and GE DSTe 16 slice PET/CT system. Specific organ doses with $^{137}Cs$ transmission scan, high quality CT scan and topogram in philips GEMINI PET/CT system were measured. Specific organ doses with CT scan for attenuation map, CT scan for diagnosis and topogram in GE DSTe PET/CT system were also measured. The organs were selected based on ICRP60 recommendation. The TLDs used for measurements were selected for within an accuracy of ${\pm}5%$ and calibrated in 10 MV X-ray radiation field. The effective doses for $^{137}Cs$ transmission scan, high qualify scan, and topogram in Philips GEMINI PET/CT system were $0.14{\pm}0.950,\;29.49{\pm}1.508\;and\;0.72{\pm}0.032mSv$ respectively. The effective doses for CT scan to make attenuation map, CT scan to diagnose and topogram in GE DSTe PET/CT system were $20.06{\pm}1.003,\;24.83{\pm}0.805\;and\;0.27{\pm}0.008mSv$ respectively. We evaluated the total effective dose by adding effective dose for PET Image. The total PET/CT doses for Philips GEMINI PET/CT (Topogram+$^{137}Cs$ transmission scan+PET, Topogram+high qualify CT+PET) and GE DSTe PET/CT (Topogram +CT for attenuation map+ PET, Topogram+diagnostic CT+ PET) are $7.65{\pm}0.951,\;37.00{\pm}1.508,\;27.12{\pm}1.003\;and\;31.89{\pm}0.805mSv$ respectively. Further study may be needed to be peformed to find optimal PET/CT acquisition protocols for reducing the patient exposure with good image qualify.