• Clinical and Experimental Pediatrics
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• v.49 no.11
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• pp.1158-1166
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• 2006

Purpose : The purpose of this study is to make a diagnostic classification and discuss a diagnostic strategy of floppy infants by investigating clinical, neurological, electrophysiological, and genetic analysis of infants admitted to intensive care units with the complaint of hypotonia. Methods : A retrospective study was performed from Jan. 1993 to Dec. 2005 in neonatal and pediatric intensive care units of Seoul National University Children's Hospital. Clinical features and all tests related to hypotonia were investigated. Results : There were 21 cases of floppy infants admitted to intensive care units. Final diagnosis was classified as centra (7 cases[33.3 percent]), peripheral (11 cases [52.4 percent]), and unspecified (3 cases [14.3 percent]). Among the central group, three patients were diagnosed as hypoxic ischemic encephalopathy, two patients as Prader-Willi syndrome, one patient as chromosomal disorder, and one patient as transient hypotonia. Among the peripheral group, four patients were diagnosed as myotubular myopathy, three patients as SMA type 1, two patients as congenital myotonic dystrophy, one patient as congenital muscular dystrophy, and one as unspecified motor-neuron disease. Motor power was above grade 3 on average, and deep tendon reflex was brisk in the central group. Among investigations, electromyography showed 66 percent sensitivity in the peripheral group, and muscle biopsy was all diagnostic in the peripheral group. Brain image was diagnostic in the central group, and Prader-Willi FISH or karyotyping was helpful in diagnosis in central group. Morbidity and mortality was more severe in the peripheral group Conclusion : Classification of diagnosis by clinical characteristics in this study, and application of investigations step by step, may provide an effective diagnostic strategy.

• Journal of radiological science and technology
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• v.39 no.2
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• pp.199-208
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• 2016

$^{99}mTc-MAG_3$ Renal scan is a method that acquires dynamic renal scan image by using $^{99}mTc-MAG_3$ and dynamically visualizes process of radioactive agent being absorbed to kidney and excreted continuously. Once the test starts, ratio in both kidneys in 1~2.5 minutes was measured to obtain split renal function and split renal function can be expressed in ratio based on overall renal function. This study is based on compares split renal function obtained from data acquired from posterior detector, which is a conventional renal function test method, with split renal function acquired from the geometric mean of values obtained from anterior and posterior detectors, and studies utility of attenuation compensation depending on difference in geometric mean kidney depth. From July, 2015 to February 2016, 33 patients who undertook $^{99}mTc-MAG_3$ Renal scan(13 male, 20 female, average age of 44.66 with range of 5~70, average height of 160.40cm, average weight of 55.40kg) were selected as subjects. Depth of kidney was shown to be 65.82 mm at average for left and 71.62 mm at average for right. In supine position, 30 out of 33 patients showed higher ratio of deep-situated kidney and lower ratio of shallow-situated kidney. Such result is deemed to be due to correction by attenuation between deep-situated kidney and detector and in case where there is difference between the depth of both kidneys such as, lesions in or around kidney, spine malformation, and ectopic kidney, ratio of deep-situated kidney must be compensated for more accurate calculation of split renal function, when compared to the conventional test method (posterior detector counting).

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.4
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• pp.293-298
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• 2010

Purpose: The objective of the present study was to determine the capability of electrospun silk fibroin as a biomaterial template for bone formation when mixed with nano-hydoxyapatite in vivo. Materials and Methods: Ten New Zealand white rabbits were used for this study and bilateral round shaped defects were formed in the parietal bone (diameter: 8.0 mm). The electrospun silk fibroin was coated by nano-hydroxyapatite and grafted into the right parietal bone (experimental group). The left side (control group) did not receive a graft. The animals were sacrificed at 6 weeks and 12 weeks, humanly. The microcomputerized tomogram (${\mu}CT$) was taken for each specimen. Subsequently, they were undergone decalcification and stained for the histological analysis. Results: The average value of all measured variables was higher in the experimental group than in the control at 6 weeks after the operation. BMC in the experimental group at 6 weeks after operation was $48.94{\pm}19.25$ and that in the control was $26.17{\pm}16.40$ (P = 0.027). BMD in the experimental group at 6 weeks after operation was $324.59{\pm}165.24$ and that in the control was $173.03{\pm}120.30$ (P = 0.044). TMC in the experimental group at 6 weeks after operation was $19.50{\pm}6.00$ and that in the control was $10.52{\pm}6.20$ (P = 0.011). TMD in the experimental group at 6 weeks after operation was $508.88{\pm}297.57$ and that in the control was $273.54{\pm}175.91$ (P = 0.06). Gross image of both groups showed higher calcification area at 12 weeks than them in 6 weeks. The average value of ${\mu}CT$ analysis was higher at 12 weeks than that in 6 weeks in both groups. BMC in the experimental group at 12 weeks after operation was $51.21{\pm}8.81$ and that in the control was $33.47{\pm}11.13$ (P = 0.010). BMD in the experimental group at 12 weeks after operation was $323.39{\pm}21.54$ and that in the control was $197.75{\pm}76.23$ (P = 0.012). TMC in the experimental group at 12 weeks after operation was $21.44{\pm}5.30$ and that in the control was $13.31{\pm}4.17$ (P = 0.008). TMD in the experimental group at 12 weeks after operation was $524.47{\pm}19.37$ and that in the control was $299.60{\pm}136.20$ (P = 0.016). Conclusion: The rabbit calvarial defect could be successfully repaired by electrospun silk nano-fiber combined with nano-hydroxyapatite.

• Progress in Medical Physics
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• v.20 no.1
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• pp.1-6
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• 2009

For HDR intracavitary brachytherapy with ovoids and a tandem, we compared the dose discrepancy of treatment plans using two different Ir-192 sources (microSelectron, Varian) and generated on two different treatment planning systems (PLATO, BrachyVision). The treatment plans of ten patient treated from Oct. 2007 to Jan. 2008 were selected for these comparisons. For the comparison of dose calculation using different sources, the average discrepancies were $-0.91{\pm}0.09%$, $-0.27{\pm}0.07%$, $0.22{\pm}0.39%$, and $0.88{\pm}0.37%$ in total treatment time and at B-point and ICRU bladder and rectum reference point, respectively. Comparing the two systems, the average dose discrepancies between treatment planning programs were $-0.22{\pm}0.42%$, $-0.25{\pm}0.29%$, $-0.23{\pm}0.63%$, and $-0.17{\pm}0.76%$, and the average dose discrepancies between positioning methods (PLATO with film and BrachyVision with digitial image) were $-0.61{\pm}0.59%$, $-0.77{\pm}0.45%$, $-0.72{\pm}1.70%$, and $0.35{\pm}2.82%$ at A-point, B-point, and ICRU bladder and rectum reference points, respectively. The rectal dose discrepancies between two systems were reached 5.87%. The difference in the dwell position expected by each TPS are mainly affected by the differences in the positioning method in TPSs and have an effect on dose calculations of rectal and bladder located in AP direction.

• Progress in Medical Physics
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• v.19 no.1
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• pp.49-55
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• 2008

This study aims to conduct the comparative analysis of the radiation dose according to before and after the calibration of the ionization chamber used for measuring radiation dose in the MDCT, as well as of $CTDI_w$ according to temperature and pressure correction factors in the CT room. A comparative analysis was conducted based on the measured MDCT (GE light speed plus 4 slice, USA) data using head and body CT dosimetric phantom, and Model 2026C electrometer (RADICAL 2026C, USA) calibrated on March 21, 2007. As a result, the $CTDI_w$ value which reflected calibration factors, as well as correction factors of temperature and pressure, was found to be the range of $0.479{\sim}3.162mGy$ in effective radiation dose than the uncorrected values. Also, under the routine abdomen routine CT image acquisition conditions used in reference hospitals, patient effective dose was measured to indicate the difference of the maximum of 0.7 mSv between before and after the application of such factors. These results imply that the calibration of the ion chamber, and the correction of temperature and pressure of the CT room are crucial in measuring and calculating patient effective dose. Thus, to measure patient radiation dose accurately, the detailed information should be made available regarding not only the temperature and pressure of the CT room, but also the humidity and recombination factor, characteristics of X-ray beam quality, exposure conditions, scan region, and so forth.

• Journal of the Korean Magnetics Society
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• v.26 no.3
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• pp.92-98
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• 2016

To aim of this study was to assess the full scan and half scan of imaging with half scan factor. Patients without a cerebral vascular disease (n = 30) and were subject to the full scan half scan, and set a region of interest in the cerebral artery from the three regions (C1, C2, C3) in the range of 7 to 8 mm. MIP (maximum intensity projection) to reconstruct the images in signal strength SNR (signal to noise ration), PSNR (peak signal noise to ratio), RMSE (root mean square error), MAE (mean absolute error) and calculated by paired t-test for use by statistics were analyzed. Scan time was half scan (4 minutes 53 seconds), the full scan (6 minutes 04 seconds). The mean measurement range (7.21 mm) of all the ROI in the brain blood vessel, was the SNR of the first C1 is completely scanned (58.66 dB), half-scan (62.10 dB), a positive correlation ($r^2=0.503$), for the second C2 SNR is completely scanned (70.30 dB), half-scan (74.67 dB) the amount of correlation ($r^2=0.575$), third C3 of a complete scan SNR (70.33 dB), half scan SNR (74.64 dB) in the amount of correlation between the It was analyzed with ($r^2=0.523$). Comparative full scan with half of SNR ($4.75{\pm}0.26dB$), PSNR ($21.87{\pm}0.28dB$), RMSE ($48.88{\pm}1.61$), was calculated as MAE ($25.56{\pm}2.2$). SNR is also applied to examine the half-scans are not many differences in the quality of the two scan methods were not statistically significant in the scan (p-value > .05) image takes less time than a full scan was used.

• Journal of the Korean Society of Radiology
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• v.12 no.1
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• pp.39-46
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• 2018

The purpose of this study was to determine suitable angle of Tibia-foot and the X-ray tube for scaphoid in foot X-ray examination. A total of twenty patients(mean age $32.12{\pm}years)$ are participated in this study. In the positions of Foot AP, internal and external oblique, tibia-foot angle was defined as $90^{\circ}$ and $135^{\circ}$, and x-ray tube angle was defined as $0^{\circ}$, $5^{\circ}$, $10^{\circ}$, $15^{\circ}$ and $20^{\circ}$ respectively. The image quality was evaluated with blind test yielding scores ranging from 0 to 5 by the evaluation team consisted of 2 radiogical technologists, 2 radiologists, and 2 orthopedic surgeons. In case of Foot AP position, the degree of overlap between cuneiform and navicular was 3% and the blind test result was 4.89 at tibia-foot angle of $90^{\circ}$ and $15^{\circ}$ X-ray tube angle. When the tibia-foot angle is $135^{\circ}$, the degree of overlap was 5%, also the blind test result was 4.30 at $15^{\circ}$ X-ray tube angle. The degree of overlap and blind test result were 30% and 3.75 respectively at $0^{\circ}$ X-ray tube angle. In case of internal oblique position, at tibia-foot angle of $90^{\circ}$ and $0^{\circ}$ X-ray tube angle, the degree of overlap was 4% and the blind test result was 4.70. The 5% overlapping and highest score as 4.55 were obtained on tibia-foot angle of $135^{\circ}$ and $0^{\circ}$ X-ray tube angle. In case of external oblique position, at tibia-foot angle of $90^{\circ}$ and $15^{\circ}$ X-ray tube angle, the degree of overlap was 4% and the blind test score was 4.85. The 5% overlapping and highest score as 4.75 were obtained on tibia-foot angle of $135^{\circ}$ and $15^{\circ}$ X-ray tube angle. In conclusion, we confirmed suitable angle of tibia-foot and X-ray tube for scaph46oid in foot X-ray examination in this study. These findings will be helpful for us to reading for navicular fracture.

• Radiation Oncology Journal
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• v.15 no.3
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• pp.215-224
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• 1997

Purpose : Stereotactic radiosurgery with external beam irradiation successfully obliterates carefully selected intracranial arteriovenous malformation (AVM) . We Present clinical and radiological long term results after treatment with a single high dose irradiation using a linear accelerator. Materials and Methods : Rrom January 1991 to June 1994, fifteen patients with intracranial AVM were treated in our hospital with the stereotactic radiosurgery using a linear accelerator. The radiation was delivered using a 6 MV linear accelerator. The prescribed doses at the isocenter varied from 1800 to 2500cGy (median : 2000cGy) and were given as a sin91e fraction. The radiation doses at the periphery of the lesion typically corresponded to the 80-90% isodose line. In 14 patients, complete clinical and/or radiological follow-up examination were available. Results : Angiography was available in 13 patients with a follow-up Period from 18 months to 27 months. Of 13 patients, the overall complete obliteration rate was 92.3% (12 patients). This incidence did not correlate with lesion size. Seizure, headache and progressive neurologic deficit were complete recovered. One Patient experienced hemorrhage at 2 months after treatment. One patient developed radiation induced brain edema in the white matter surrounding nidus at 16 months after treatment and showed complete resolution of the edema in MR image obtained at 27 months after treatment. After a follow-up period of up to 6 years, no radiation induced severe late complications occurred. Conclusion : We conclude that stereotactic radiosurgery using a linear accelerator is an effective and safe therapy for symptomatic and surgically inaccessible intracranial AVMs and the results compare favorably to the more expensive and elaborate systems that are currently available for stereotactic radiosurgery.

• Progress in Medical Physics
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• v.17 no.2
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• pp.89-95
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• 2006

The purpose of this study was to evaluate the radiation doses during CT transmission scan by changing tube voltage and tube current, and to estimate the radiation dose during our clinical whole body $^{137}Cs$ transmission scan and high quality CT scan. Radiation doses were evaluated for Philips GEMINI 16 slices PET/CT system. Radiation dose was measured with standard CTDI head and body phantoms in a variety of CT tube voltage and tube current. A pencil ionization chamber with an active length of 100 mm and electrometer were used for radiation dose measurement. The measurement is carried out at the free-in-air, at the center, and at the periphery. The averaged absorbed dose was calculated by the weighted CTDI ($CTDI_w=1/3CTDI_{100,c}+2/3CTDI_{100,p}$) and then equivalent dose were calculated with $CTDI_w$. Specific organ dose was measured with our clinical whole body $^{137}Cs$ transmission scan and high quality CT scan using Alderson phantom and TLDs. The TLDs used for measurements were selected for an accuracy of ${\pm}5%$ and calibrated in 10 MeV X-ray radiation field. The organ or tissue was selected by the recommendations of ICRP 60. The radiation dose during CT scan is affected by the tube voltage and the tube current. The effective dose for $^{137}Cs$ transmission scan and high qualify CT scan are 0.14 mSv and 29.49 mSv, respectively. Radiation dose during transmission scan in the PET/CT system can measure using CTDI phantom with ionization chamber and anthropomorphic phantom with TLDs. further study need to be peformed to find optimal PET/CT acquisition protocols for reducing the patient exposure with same image qualify.

• Progress in Medical Physics
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• v.18 no.2
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• pp.98-106
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• 2007

In June 2005, Yonsei University Medical Center, Severance Hospital upgraded a full-PACS system by adding twenty (5 mega pixels) Totoku ME511L flat panel LCD display devices for diagnostic interpretation purposes. Here we report upon the quantitative (or visual) acceptance testing of the twenty Totoku ME511L display devices for reflection, luminance response, luminance spatial dependency, resolution, noise, veiling glare, and display chromaticity based on AAPM TG 18 report. The tools used in the tests included a telescopic photometer, which was used as a colorimeter, illuminance meter, light sources for reflection assessment, light-blocking devices, and digital TG18 test patterns. For selected 8 flat panel displays, mean diffuse reflection coefficient ($R_d$) was $0.019{\pm}0.02sr^{-1}$. In the luminance response test, luminance ratio (LR), maximum luminance difference ($L_{max}$), and deviation of contrast response were $550{\pm}100,\;2.0{\pm}1.9%\;and\;5.8{\pm}1.8%$, respectively. In the luminance uniformity test, maximum luminance deviation was $14.3{\pm}5.5%$ for the 10% luminance of the TG18-UNL10 test pattern. In the resolution test with luminance measurement method, percent luminance (${\Dalta}L$) at the center was $0.94{\pm}0.64%$. In all cases of noise testing, rectangular target In every square in the three quadrants was visible and all 15 targets except the smallest one in the every corner pattern and the center pattern. The glare ratio (GR) was $12,346{\pm}1,995$. The color uniformity, (u',v'), was $0.0025{\pm}0.0008$. Also, the research results of qualify control guideline of primary disply devices suitable for domestic circumstance are presented All test results are in-line with the criteria recommended by AAPM TG18 report and are thus fully acceptable for diagnostic image interpretation. As a result, the acceptance testing schedule described provides not only an acceptance standard but also guidelines for quality control, optimized viewing conditions, and a means for determining the upgrading time of LCD display devices for diagnostic interpretation.