• Investigative Magnetic Resonance Imaging
• /
• v.17 no.4
• /
• pp.286-293
• /
• 2013

Purpose : The objective of this study was to analyze the brain volume according to the brain image of healthy adults in the 20s taken with different inversion time (TI). Materials and Methods: Brain images of healthy adults in the 20 s were acquired using magnetization prepared rapid acquisition gradient echo (MPRAGE) pulse sequence with 1.5 mm thickness of pieces and four inversion times (1100 ms, 1000 ms, 900 ms, 800 ms). The acquired brain images were analyzed to measure the volume of white matter (WM), gray matter (GM), intracranial volume (ICV). The statistical difference according to brain volume and gender was analyzed for each TI. Results: The brain volume calculated using Freesurfer was WM$486.52{\pm}48.64cm^3$ and GM=$646.83{\pm}57.12cm^3$ in mean when adjusted by mean ICV=$1278.94{\pm}154.92cm^3$. Men's brain volume(WM, GM, ICV) was larger than women's brain volume. In the intrarater reliability test, all of the intraclass correlation coefficients were high (0.992 for WM, 0.988 for GM, and 0.997 for ICV). In the repeated measures analysis of variance, GM and ICV did not show a significant difference at each TI (GM p=0.143, ICV p=0.052), but WM showed a significant (p=0.001). In the linear structure relation analysis, all of the Pearson correlation coefficients were high. Conclusion: WM, GM, and ICV indicated high reliability and solid linear structure relations, but WM showed significant differences at each TI. The brain volume of healthy adults in the 20s could be used in comparison with that of patients for reference purposes and to predict the structural change of brain. It would be needed to conduct additional studies to examine the contract, SNR, and lesion detection ability according to variable TI.

• Radiation Oncology Journal
• /
• v.18 no.2
• /
• pp.101-106
• /
• 2000

Purpose : This study was peformed to evaluate the effectiveness and tolerance of craniospinal irradiation for patients with modulloblastoma and to define the optimal radiotherapeutic regimen. Materials and Methods : We retrospectively analyzed the records of 43 patients with modulloblastoma who were treated with external beam craniospinal radiotherapy at our institution between May, 1984 and April, 1998. Median follow up period was 47 months with range of 18 to U months. Twenty seven patients were male and sixteen patients were female, a male to female ratio of 1.7:1. Surgery consisted of biopsy alone in 5 patients, subtotal excision in 24 patients, and gross total excision in 14 patients. All of the patients were treated with craniospinal irradiation. All of the patients except four received at least 5,000 cGy to the posterior fossa and forty patients received more than 3,000 cGy to the spinal cord. Results : The overall survival rates at 5 and 7 years for entire group of patients were 57$\%$ and 56$\%$, respectively. Corresponding disease free survival rates were 60$\%$ and 51$\%$, respectively, The rates of disease control in the posterior fossa were 77$\%$ and 67$\%$ at 5 and 7 years. Gross total excision and subtotal excision resulted in 5 year overall survival rates of 76$\%$ and 66$\%$, respectively, In contrast, those patients who had biopsy alone had a 5 year survival rate of only 40$\%$. Posterior fossa was a component of failure in 11 of the 18 recurrences. Seven recurrences were isolated to the posterior fossa. Four patients had neuraxis recurrences, three had distant metastasis alone and four had multiple sites of failure, all involving the primary site. Conclusion : Craniospinal irradiation for patients with moduiloblastoma is an effective adjuvant treatment without significant treatment related toxicitles. There is room for Improvement in terms of posterior fossa control, especially in biopsy alone patients. The advances in radiotherapy including hypefractionation, stereotactic radiosurgery and 3D conformal radiotherapy would be evolved to improve the tumor control rate at primary site.

• Journal of radiological science and technology
• /
• v.35 no.4
• /
• pp.299-308
• /
• 2012

To perform patient dose surveys in major interventional radiography procedures as a mean of inter-institutional comparison and of establishing reference dose levels with the ultimate goal of optimizing patient doses in the field of interventional radiography. We reviewed international patient dose survey data in the literature and measured patient dose in major interventional radiography procedures (TACE, AVF, PTBD, TFCA, GDC embolization). ESD(Entrance Skin Dose) was measured using TLD chips attached to the patient skin and ED(Effective Dose) was calculated using angiography unit-derived DAP. A survey of patient dose in interventional radiography procedures were also performed with a questionnaire for interventional radiologists and we proposed a guideline for optimizing patient doses in the field of interventional radiology. The patient dose survey data in interventional radiography procedures were very rare in literature compared with those in diagnostic radiography procedures. In TACE, the mean ED was 25.43 mSv and the mean ESD was 511.75 mGy. The mean ED of TACE was not high, but the cumulative dose should be checked, due to longer procedure TACE. In TFCA, the mean ED was 22.6 mSv and it was relatively high compared with data of other countries. In GDC embolization, the mean ED was not available, because GDC embolization was performed with old Image-Intensifier-type unit and there has no unit-installed ionization chamber. Also, the mean ESD of GDC embolization was up to 2,264 mGy and further studies are needed to calculate the net ED of GDC embolization. Patient dose occurred during interventional radiography procedures are high related with the difficulty of the procedure, fluoroscopy time, the number of angiographies and the treatment protocol. Therefore, continuous education and efforts should be made to optimize the patient dose in the field of interventional radiology.

• Journal of Radiation Protection and Research
• /
• v.25 no.1
• /
• pp.31-36
• /
• 2000

In radiotherapy, it may happen to radiate surrounding normal tissue because of inconsistent field size by changing patient position during treatment. We are going to analyze errors reduced by using immobilization device with Electonic portal imaging device(EPID) in this study. We had treated the twenty-one patients in pelvic region with 10 MV X-ray from Aug. 1998 to Aug. 1999 at Chungnam National University Hospital. All patients were treated at supine position during treatment. They were separated to two groups, 11 patients without device and 10 patients with immobilization device. We used styrofoam for immobilization device and measured the errors of anterior direction for x, y axis and lateral direction for z, y axis from simulation film to EPID image using matching technique. For no immobilization device group, the mean deviation values of x axis and y axis are 0.19 mm. 0.48 mm, respectively and the standard deviations of systematic deviation are 2.38 mm, 2.19 mm, respectively and of random deviation for x axis and y axis are 1.92 mm. 1.29 mm, respectively. The mean deviation values of z axis and y axis are -3.61 mm. 2.07 mm, respectively and the standard deviations of systematic deviation are 3.20 mm, 2.29 mm, respectively and of random deviation for z axis and y axis are 2.73 mm. 1.62 mm, respectively. For immobilization device group, the mean deviation values of x axis and y axis are 0.71 mm. -1.07 mm, respectively and the standard deviations of systematic deviation are 1.80 mm, 2.26 mm, respectively and of random deviation for x axis and y axis are 1.56 mm. 1.27 mm, respectively. The mean deviation values of z axis and y axis are -1.76 mm. 1.08 mm, respectively and the standard deviations of systematic deviation are 1.87 mm, 2.83 mm, respectively and of random deviation for x axis and y axis are 1.68 mm, 1.65 mm, respectively. Because of reducing random and systematic error using immobilization device, we had obtained good reproducibility of patient setup during treatment so that we recommend the use of immobilization device in pelvic region of radiation treatment.

• Tuberculosis and Respiratory Diseases
• /
• v.54 no.1
• /
• pp.80-90
• /
• 2003

Background : Goblet cell hyperplasia is a critical pathological feature in hypersecretory diseases of the airways. A bacterial infection of the lung is also known to induce inflammatory responses, which can lead to the overproduction of mucus. Recently, mucin synthesis in the airways has been reported to be regulated by neutrophilic inflammation-induced epidermal growth factor receptor (EGFR) expression and activation. In addition, it was reported that migration of the activated neutrophils is dependent on the matrix metalloproteinases (MMPs), especially MMP-9. In this study, bacterial lipopolysaccharide (LPS)-induced goblet cell hyperplasia and mucus hypersecretion by EGFR cascade, resulting from the MMPs-dependent neutrophilic inflammation were investigated in the rat airways. Methods : Pathogen-free Sprague-Dawley rats were studied in vivo. Various concentrations of LPS were instilled into the trachea in $300{\mu}{\ell}$ PBS (LPS group). Sterile PBS ($300{\mu}{\ell}$) was instilled into the trachea of the control animals (control group). The airways were examined on different days after instilling LPS. For an examination of the relationship between the LPS-induced goblet cell hyperplasia and MMPs, the animals were pretreated 3 days prior to the LPS instillation and daily thereafter with the matrix metalloproteinase inhibitor (MMPI; 20 mg/Kg/day of CMT-3; Collagenex Pharmaceuticals, USA). The neutrophilic infiltration was quantified as a number in five high power fields (HPF). The alcian blue/periodic acid-Schiff (AB/PAS) stain were performed for the mucus glycoconjugates and the immunohistochemical stains were performed for MUC5AC, EGFR and MMP-9. Their expressions were quantified by an image analysis program and were expressed by the percentage of the total bronchial epithelial area. Results : The instillation of LPS induced AB/PAS and MUC5AC staining in the airway epithelium in a time- and dose-dependent manner. Treatment with the MMPI prevented the LPS-induced goblet cell hyperplasia significantly. The instillation of LPS into the trachea induced also EGFR expression in the airway epithelium. The control airway epithelium contained few leukocytes, but the intratracheal instillation of LPS resulted in a neutrophilic recruitment. A pretreatment with MMPI prevented neutrophilic recruitment, EGFR expression, and goblet cell hyperplasia in the LPS-instilled airway epithelium. Conclusion : Matrix metalloproteinase is involved in LPS-induced mucus hypersecretion, resulting from a neutrophilic inflammation and EGFR cascade. These results suggest a potential therapeutic role of MMPI in the treatment of mucus hypersecretion that were associated with a bacterial infection of the airways.

• Radiation Oncology Journal
• /
• v.24 no.3
• /
• pp.185-191
• /
• 2006

[ $\underline{Purpose}$ ]: Standardization quality assurance (QA) program of CyberKnife for suitable circumstances in Korea has not been established. In this research, we investigated the development of QA program for CyberKnife and evaluation of the feasibility under applications. $\underline{Materials\;and\;Methods}$: Considering the feature of constitution for systems and the therapeutic methodology of CyberKnife, the list of quality control (QC) was established and divided dependent on the each period of operations. And then all these developed QC lists were categorized into three groups such as basic QC, delivery specific QC, and patient specific QC based on the each purpose of QA. In order to verify the validity of the established QA program, this QC lists was applied to two CyberKnife centers. The acceptable tolerance was based on the undertaking inspection list from the CyberKnife manufacturer and the QC results during last three years of two CyberKnife centers in Korea. The acquired measurement results were evaluated for the analysis of the current QA status and the verification of the propriety for the developed QA program. $\underline{Results}$: The current QA status of two CyberKnife centers was evaluated from the accuracy of all measurements in relation with application of the established QA program. Each measurement result was verified having a good agreement within the acceptable tolerance limit of the developed QA program. $\underline{Conclusion}$: It is considered that the developed QA program in this research could be established the standardization of QC methods for CyberKnife and confirmed the accuracy and stability for the image-guided stereotactic radiotherapy.

• Journal of Sasang Constitutional Medicine
• /
• v.10 no.1
• /
• pp.215-233
• /
• 1998

The object of this study is 27 patients who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center during 6 months from January 1998 to June 1998. We proceeded the judgment of Sasang Constitution by Questionaire of Sasang Constitution Classification II(QSCC II). The following conclusion were made in comparison with Questionaire of Sasang Constitution Classification II(QSCC II) and Questionaire of Pusan Sasang seminar. 1. The subject of "the facial type is small and sharp" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Taeumin group and Soyangin group. 2. The subject of "the walking form is fast and shake the body" is significant differences in Sasang Constitution classification. The frequency of Taeumin group and Soeumin group is less than Soyangin group. 3. The subject of "the skin type is white and thin" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Soyangin group, and the frequency of Taeumin group is low marks. 4. The subject of "the skin type is tender and dry" is significant differences in Sasang Constitution classification. The frequency of Taeumin group and Soyangin group is less than Soeumin group. 5. The subject of "the image of face is smart" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Taeumin group and the frequency of Soyangin group is low marks. 6. The subject of "the sweating type is not sweatier" is significant differences in Sasang Constitution classification. The frequency of Taeumin group and Soeumin group is less than Soyangin group. 7. The subject of "the desire of eating is changeable accoding to emotion" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Taeumin group and Soyangin group. 8. The subject of "the health is changeable accoding to the type of stool" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Soyangin group and the frequency of Taeumin group is low marks. 9. The subject of "the type of voiding is changeable accoding to the drinking when they have a fever" is significant differences in Sasang Constitution classification. The frequency of Taeumin group and Soyangin group is less than Soeumin group. 10. The subject of "the skin type is soft" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Taeumin group and Soyangin group. 11. The subject of "the chief complaint is the forgetfulness" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is less than Taeumin group and Soyangin group.

• Investigative Magnetic Resonance Imaging
• /
• v.13 no.1
• /
• pp.31-39
• /
• 2009

Purpose : This study proposes the keyhole method in order to improve the time resolution of the proton resonance frequency(PRF) MR temperature monitoring technique. The values of Root Mean Square (RMS) error of measured temperature value and Signal-to-Noise Ratio(SNR) obtained from the keyhole and full phase encoded temperature images were compared. Materials and Methods : The PRF method combined with GRE sequence was used to get MR temperature images using a clinical 1.5T MR scanner. It was conducted on the tissue-mimic 2% agarose gel phantom and swine's hock tissue. A MR compatible coaxial slot antenna driven by microwave power generator at 2.45GHz was used to heat the object in the magnetic bore for 5 minutes followed by a sequential acquisition of MR raw data during 10 minutes of cooling period. The acquired raw data were transferred to PC after then the keyhole images were reconstructed by taking the central part of K-space data with 128, 64, 32 and 16 phase encoding lines while the remaining peripheral parts were taken from the 1st reference raw data. The RMS errors were compared with the 256 full encoded self-reference temperature image while the SNR values were compared with the zero filling images. Results : As phase encoding number at the center part on the keyhole temperature images decreased to 128, 64, 32 and 16, the RMS errors of the measured temperature increased to 0.538, 0.712, 0.768 and 0.845$^{\circ}C$, meanwhile SNR values were maintained as the phase encoding number of keyhole part is reduced. Conclusion : This study shows that the keyhole technique is successfully applied to temperature monitoring procedure to increases the temporal resolution by standardizing the matrix size, thus maintained the SNR values. In future, it is expected to implement the MR real time thermal imaging using keyhole method which is able to reduce the scan time with minimal thermal variations.

• The Journal of Korean Academy of Prosthodontics
• /
• v.46 no.2
• /
• pp.169-174
• /
• 2008

Statement of problem: Changes of the marginal bone around dental implants have significance not only for the functional maintenance but also for the esthetic success of the implant. It was proposed that bone-retention elements such as microthreads at the coronal part of implant might help maintain the marginal bone level. Purpose: This study was designed to evaluate the effect of microthread configuration within the marginal coronal portion of the implant fixture at the marginal bone changes after loading around two different external hex implants. Material and methods: Twenty-four patients were included and randomly assigned to treatment with $Br{{\aa}}nemark$ system implants (Group 1, rough-surfaced implants, n=20) and Oneplant system implants (Group 2, rough-surfaced neck with microthreads, n=20). Clinical and radiographic examinations were conducted at baseline (implant loading) and 1 year postloading. Data analysis was performed by the SAS statistical package version 9.1.3 (SAS Institute, Cary, NC, USA) and the final model was calculated by the MIXED procedure (three-level ANCOVA) for marginal bone change of each test group at baseline and 1 year follow-up. Results: Comparing to baseline, significant differences were noted in marginal bone level changes for the 2 groups at 1 year follow-up (P<0.05). Group 1 had a mean crestal bone level changes of $0.83{\pm}0.31mm$; Group 2 had a mean crestal bone level changes of $0.44{\pm}0.36mm$. Rough-surfaced with microthreads implants showed significantly less marginal bone loss than rough surfaced neck without microthread implants. Conclusion: A rough surface with microthreads at the implant was beneficial design to maintain the marginal bone level against functional loading.

• Journal of Korean society of Dental Hygiene
• /
• v.5 no.2
• /
• pp.201-218
• /
• 2005

The purpose of this study was to examine how dentists perceived dental coordinators including their education, hiring criteria, working condition and job. It's basically attempted to help define the job and role of 5 and to suggest how they should be nurtured. The subjects in this study were dentists at dental hospitals and clinics where dental coordinators were employed among approximately 200 dental institutions in Seoul, Cyeonggi province and Incheon. After a survey was conducted in June 2005, answer sheets from 99 respondents were analyzed. The findings of the study were as follows: 1. Regarding education for dental coordinators, 99.9% of the dentists investigated felt the need for separate education programs for dental coordinators, 42.4% knew what would-be dental coordinators learned about, and 81.8% considered it necessary for them to take intermediate or higher courses. An organization affiliated with the Korea Dental Hygienists Association was viewed as the best institute to educate dental coordinators, and educational institutes that included a department of dental hygiene was looked upon as the second best one. 68.7% believed that dental coordinators should take an official examination to test their qualifications, and concerning educational subsidy, the largest group of the dentists thought that a certain amount of subsidy should be provided. 2. As for coordinator hiring, the top priority was the impression(look) of applicants(55%), followed by adjustability to existing employees(24.5%) and professional competency(17.3%). As to the route of hiring, 41.4 percent, the largest group, reeducated some of existing employees, and dental hygienists were regarded as the best personnels to serve as a coordinator. Concerning job performance, they put the most emphasis on interpersonal relationship, which was followed by executive ability, impression and career, 58.6% the largest group, believed that dental coordinators should have a three-year or higher career to work at a dental institute. 3. As to working conditions, 75.7%, the largest group, paid dental coordinators based on their job performance, and 23.2%, the second largest group, had their pay equal to that of dental hygienists, 88.9% allowed them to determine their own retirement age. 4. In regard to their perception of dental coordinators, the largest number of the dentists considered it necessary for them to keep receiving education(4.29), and the second largest group felt that they served to enhance the image of dental institutes(4.18). The third largest group thought that they contributed to letting patients more satisfied with the quality of dental services. But they tended not to agree that their turnover rate was low(3.04), and they didn't find them to receive appropriate education, either(3.10). 5. The current major job of coordinators associated with customer services was handling appointments with customers(91.9%), treating unsatisfied customers(85.9%), and controling waiting time(84.8%). Regarding self-management, coordinators directed their energy into having good manners(89.9%), acquiring fundamental dental knowledge(84.8%), and learning how to treat customers(83.8%). Concerning hospital affairs handling, they were most responsible for information desk(87.9%), which was followed by receiving(86.9%). As a result of investigating what type of job the dentists hoped dental coordinators to fulfill in consideration of their career, their age and type of investment, the dentists wanted them the most to speak a foreign language, which belonged to the field of self-management.